Antibodies to high-frequency antigens may decrease the quality of transfusion support: an observational study

There is only little information on the transfusion support of patients with antibodies to high-frequency RBC antigens.

In cooperation with reference laboratories and transfusion services in Austria, Germany, and Switzerland, the transfusion support provided to hospitalized patients identified as having such antibodies was reviewed during a 20-month period.

A total of 52 patients with antibodies to high-frequency antigens were treated in hospitals. Twenty-two of them received 104 units of antigen-negative RBCs. In 23 cases, a deviation from the standard transfusion policy (e.g., transfusion of antigen-incompatible units) occurred. The use of frozen or fresh units varied amongst the different countries but did not affect the rate of deviation from protocol. About 20 percent of all units were supplied internationally. Four antibody specificities, anti-Kpb, anti-Vel, anti-Lub, and anti-Yta, were identified in two-thirds of the patients.

This survey indicated that transfusion support was unsatisfactory in about one-third of the hospitalized patients with antibodies to high-frequency antigens. Maintaining a rapidly accessible stock of just four types of rare blood units would ensure adequate transfusion support for most of these patients.