Red cell alloimmunization in multitransfused hepatobiliary patients at hospital Selayang

Transfusion support is vital for the management of patients with hepatobiliary disease. Repeated blood transfusions increase the risk of alloimmunization, i.e., the development of alloantibodies, which might lead to difficulties in blood crossmatching.

This study aims to: (1) determine the incidence of red blood cell (RBC) alloimmunization and (2) evaluate the associations between antibody development and demographic factors among hepatobiliary patients.

ABO blood grouping, antibody screening, antibody identification and crossmatch were done on all patients samples included in the study.

A cross-sectional study was conducted from February 2021 to September 2021, with a total of 132 samples from hepatobiliary patients. The relationships between RBC alloimmunization in transfused hepatobiliary patients and demographic factors (gender, age, and history of transfusion) were assessed by binary logistic regression.

Overall, 67.4% of the patients developed alloimmunization. The majority had a single alloantibody (75.2%) and the most frequently identified antibody specificities were anti-E (37.6%), anti-c (12.8%), anti-Mia (14.4%), and anti-Kidd (11.2%). The predominant antibodies were those against the Rh system (58.4%). Female patients recorded the highest incidence of alloimmunization (69.8%). Female patients also demonstrated a higher tendency to produce both anti-E + anti-c than male patients.

The prevalence of RBC alloimmunization is high among hepatobiliary patients and it may cause complications requiring multiple transfusions. The number of transfused packed cells has been clearly shown to be proportionally significant with the risk for alloimmunization in hepatobiliary patients. Hence, this study highlights the importance of immunohematology tests before blood transfusion.