A cross-sectional study to evaluate the frequency of red cell auto/allo immunization in pediatric patients

Red cell alloimmunization is a well-recognized entity which has implications on compatibility testing, post transfusion hemoglobin rise and adverse transfusion reactions. We present a study to evaluate the frequency and specificity of autoimmunization and alloimmunization against major and minor red cell antigens in pediatric age group.

The prospective, cross sectional observational study involved data collection from 18,292 blood requisition forms received by the department of Transfusion Medicine. All the pediatric requisitions (≤ to 18 years), other than thalassemia and SCD were analyzed. Detailed immunohematological work up was performed on the blood sample of the patient routinely received with each form.

Auto/Alloimmunization was found in 164/18292 patients (0.89%). Auto antibodies were seen in 49 patients; alloantibodies were present in 33 patients and 2 patients had both auto and allo antibodies. 38 neonates presented with maternal history of alloimmunization (1.26%). The rate of auto antibody positivity was 0.27% and alloimmunization was seen in 0.4%. DAT positivity (without auto or alloantibody) was seen in 42 samples (0.23%). The maximum alloantibodies were against MNS system antigens (10/22) followed by Rh system antigens (6/22).

The rate of red cell alloimmunization in pediatric patients who are not on regular lifelong transfusions was found to be much less compared to adult population.