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Should we be screening for anti-Js(a)?

Nancy M Nikolis1, Fouad Boctor, William Andrew Heaton

  • 1Transfusion Service and Donor Services, North Shore University Hospital, Manhasset, NY 11030, USA.

Immunohematology
|February 24, 2012
PubMed

Insights

The anti-Js(a) antibody may be missed in 30-40% of patients. Current red blood cell (RBC) screening methods may not detect Js(a) when it is the only antibody present.

Area of Science:

  • Transfusion Medicine
  • Immunology
  • Hematology

Background:

  • The Js(a) antigen is a significant red blood cell (RBC) antigen.
  • Alloantibodies to RBC antigens can cause transfusion reactions.
  • Current screening methods may not detect all clinically significant antibodies.

Purpose of the Study:

  • To determine the frequency of anti-Js(a) alloantibodies in a patient database.
  • To evaluate the detection rate of anti-Js(a) when present alone or with other antibodies.
  • To assess the need for Js(a) inclusion in routine antibody screening.

Main Methods:

  • Analysis of a historic patient database from North Shore University Hospital.
  • Review of alloantibody screening results, focusing on anti-Js(a).
  • Calculation of the frequency of anti-Js(a) and its co-occurrence with other antibodies.

Main Results:

  • Anti-Js(a) was not detected in 30-40% of patients when it was the sole antibody.
  • Since 1996, anti-Js(a) has only been detected in conjunction with other antibodies.
  • Approximately 1.7% of patients (90 patients/year) are exposed to the Js(a) antigen.

Conclusions:

  • Current antibody screening methods may fail to detect anti-Js(a) as a sole antibody.
  • The clinical significance of anti-Js(a) warrants further investigation.
  • Additional studies are needed to determine if Js(a) should be incorporated into antibody screening cells.

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