Red blood cell alloimmunization among rhesus D-negative patients in a teaching hospital in Northeastern Malaysia
Noorazlina Shaari1, Mohd Nazri Hassan1, Noor Haslina Mohd Noor1
1Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Malaysia.
Background:
Rhesus D (RhD) negative is considered a rare blood group in Asian country including Malaysia. Thus, the red blood cell (RBC) alloimmunization among RhD negative is considered significant because the blood's availability and rarity makes it more challenging to find compatible blood. The aims of the study are to determine the prevalence, specificities of alloantibodies, and associated factors of RBC alloimmunization among RhD-negative patients admitted to our center.
Methods:
This cross-sectional study involved 562 RhD-negative patients who were admitted to Hospital Universiti Sains Malaysia from January 2011 to December 2019. Demographic, clinical, and transfusion data were collected from patients' records and laboratory information system retrospectively. The blood samples were subjected to the standard immunohematological procedure for RBC antibody screening and identification using Diamed ID gel microtyping system. Pearson's Chi-square and Fisher's exact test were used for statistical analysis and P < 0.05 was considered statistically significant.
Results:
The mean age of patients was 41-year-old, with the majority being female (71.4%), Malay (87.5%), blood group O (40.2%), and rr phenotype (64.1%). The main reason for admission was pregnancy related (48.6%) and trauma (18.7%). The prevalence of RBC alloimmunization was 3.6% (n = 20). Most of the alloimmunized patients had a single alloantibody (n = 18) and belonged to Rh antibody (n = 16). The most common alloantibody specificity was anti-D (n = 14) followed by anti-Le (n = 4). The significant associated factors with RBC alloimmunization were the history of blood transfusion (P = 0.049) and Rh phenotype (P = 0.047).
Conclusion:
The rate of RBC alloimmunization in RhD-negative patients was low. Nevertheless, it is still mandatory that there should be one standard universal protocol to identify RhD-negative patients and screening for antibody especially anti-D, which is clinically significant.
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