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Red cell alloimmunization in multitransfused patients and multiparous women
Jalada Patel1, Rinku Shukla, Snehalata Gupte
1Surat Raktadan Kendra and Research Centre, 1st Floor, Khatodara Health Centre, Near Chosath Jogani Mata Temple Udhna Magdalla Road, Surat, 394 210 Gujarat India.
Summary
Red blood cell alloimmunization occurs in multitransfused patients and multiparous women, with specific antibodies identified. Pre-transfusion and antenatal screening are recommended to prevent alloimmunization.
Area of Science:
- Immunology
- Transfusion Medicine
- Obstetrics
Background:
- Alloimmunization against red blood cell antigens is a significant concern in patients requiring transfusions and in women with multiple pregnancies.
- Understanding antibody profiles is crucial for transfusion safety and managing pregnancy outcomes.
Purpose of the Study:
- To determine the incidence of red blood cell alloimmunization.
- To characterize the thermal amplitude and specificity of detected antibodies.
- To compare alloimmunization rates in multitransfused patients and multiparous women.
Main Methods:
- Antibody screening was conducted on 504 multitransfused patients, 325 multiparous women, and 30 controls.
- Screening employed various techniques including indirect antiglobulin technique (IAT) and enhancement methods like low ionic strength solution (LISS) and polyethylene glycol (PEG) at different temperatures (4°C, 22°C, 37°C).
Main Results:
- IgM antibodies were more frequent at 4°C in multitransfused patients.
- Incidence of IgG antibodies ranged from 7.1% (enzyme method) to 10.2% (PEG and multiparous women).
- Antibodies primarily targeted Lewis, Rh, Kidd, and MN blood group systems; women with a history of poor obstetric outcomes showed higher alloimmunization rates.
Conclusions:
- Routine antibody screening is recommended before transfusions.
- Regular screening at set intervals post-transfusion and during antenatal care is advised.
- Proactive screening can mitigate risks associated with red blood cell alloimmunization.
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