Alloimmunization by blood group antigens from bone allografts

Area of Science:

• Immunology
• Transplantation Medicine
• Hematology

Background:

• Blood group antigen sensitization poses a risk in bone allografting.
• Rh-negative individuals are particularly susceptible to sensitization.
• Previous pregnancies or transfusions are not always the cause of antibody production.

Purpose of the Study:

• To raise awareness of Rh antigen sensitization risk after bone allografting.
• To identify risk factors and preventative strategies for Rh sensitization.
• To inform clinical practice regarding bone allografts in Rh-negative recipients.

Main Methods:

• Case report of two Rh-negative females experiencing sensitization.
• Analysis of antibody production post-bone allografting.
• Exclusion of pregnancy and transfusion history as causative factors.

Main Results:

• Two Rh-negative women developed multiple Rh antibodies post-transplant from Rh-positive donors.
• Sensitization was linked to red cells or stroma within the allograft.
• No history of prior sensitization through pregnancy or transfusion was identified.

Conclusions:

• Rh-negative women of childbearing age should receive Rh-negative bone allografts.
• Rh immune globulin administration is recommended for Rh-positive allografts in at-risk patients.
• Processing bone allografts to remove hemopoietic marrow and red cells may reduce sensitization risk.