Management of patients with anti-Cartwright (Yta)

Five patients with anti-Cartwright (Yta) in their serum were observed during a 14-month period. One of the patients in whom a 51Cr-labeled donor red cell survival study was done showed increased destruction of infused Yta-positive red cells while three other patients tested showed a survival of greater than 85 percent at 1 hour. None of the antibodies potentiated interaction between sensitized red cells and heterologous activated mononuclear cells. The fifth patient received many transfusions of Yta-positive red cells without any adverse reaction. Performance of a 1-hour red cell survival with 51Cr-labeled Yta-positive cells is recommended when time permits to determine whether patients with anti-Yta can receive Yta-positive red cells or, alternatively, whether they must receive Yta-negative red cells. This approach not only is the safest for the patient, but allows conservation of Yta-negative blood. Such an approach also should be used in patients with antibodies against other high-incidence antigens.