Related Experiment Videos
Multiple transfusion fail to provoke antibodies against blood cell antigens in human infants
Insights
Neonatal infants receiving multiple blood transfusions did not form red blood cell (RBC) or white blood cell (WBC) antibodies. This finding supports omitting repeat RBC compatibility testing in young infants lacking initial unexpected antibodies.
Area of Science:
- Immunology
- Pediatrics
- Transfusion Medicine
Background:
- Neonates often require multiple transfusions, increasing exposure to foreign antigens.
- Antibody formation in infants following transfusion is a concern for transfusion safety.
Purpose of the Study:
- To investigate red blood cell (RBC) and white blood cell (WBC) antibody formation in infants after multiple transfusions.
- To assess the risk of alloimmunization in neonates exposed to diverse blood products.
Main Methods:
- Studied 53 infants receiving RBC, platelet, granulocyte, and fresh-frozen plasma transfusions.
- Collected 350 serum samples for antibody screening (37°C, low-ionic-strength solution, anti-globulin phase) and room temperature testing.
- Assessed lymphocytotoxic and granulocytotoxic WBC antibodies in 13 infants.
Main Results:
- No infants developed unexpected RBC antibodies.
- Posttransfusion sera tested negative at room temperature for RBC antibodies.
- No lymphocytotoxic or granulocytotoxic WBC antibodies were detected.
Conclusions:
- Infants exposed to numerous RBC and WBC antigens did not produce alloantibodies.
- Immunologically mediated transfusion reactions are likely rare in young infants.
- Supports omitting repeat RBC compatibility testing in the first 4 months for infants with negative initial screens.
Abstract:
We conducted studies of both red cell (RBC) and leukocyte (WBC) antibody formation in infants following multiple transfusions given during the first weeks of life. Fifty-three infants received 683 RBC transfusions from 503 different donors, plus 62 platelet, 4 granulocyte, and 53 fresh-frozen plasma units during the first 4 months of life. Three hundred fifty serum samples were obtained before, during, and after the transfusions. None of the infants formed unexpected RBC antibodies when tested at 37 degrees C by a two-cell low-ionic-strength solution antibody screen that included an anti-globulin phase. Twenty posttransfusion serums were negative when tested at room temperature. Lymphocytotoxic and granulocytotoxic WBC antibodies were measured in posttransfusion serums from 13 infants, and none were found. Despite exposure to many RBC and WBC antigens, no infants produced alloantibodies against blood cell antigens. Thus, immunologically mediated transfusion reactions should be quite rare in young infants, and this study supports recommendations of the American Association of Blood Banks Standards to omit repeat RBC compatibility testing during the first 4 months of life in infants whose initial RBC antibody screens reveal no unexpected antibodies.