Alloimmunization by blood group antigens from bone allografts

The purpose of this report is to heighten awareness of the risk of blood group antigen sensitization following hone allografting. Two Rh-negative females of childbearing age developed multiple antibodies to Rh antigens following transplantation of bone from Rh-positive donors. A previous pregnancy and/or blood transfusions were ruled out as factors influencing the antibody production. It is postulated that red cells or red cell stroma in the allografts stimulated the antibody production. Therefore, young, Rh-negative bone allograft recipients at risk (especially women) should receive Rh-negative bone allografts. Alternatively, they should receive Rh immune globulin at the time of transplanting if the allograft is from an Rh-positive donor. Bone allografts processed to deplete the hemopoietic marrow and red cells should minimize the risk of blood group antibody sensitization.