No irregular erythrocyte antibodies observed after bone allografts in 144 patients

Red cell blood group antigens present in bone allografts may cause the formation of irregular erythrocyte antibodies (IEA). In the literature, 4 such cases have been described; all were Rh(D) negative females who had received Rh(D) positive bone and had made anti-Rh(D). To investigate the immunization by red cells after bone allografting, a retrospective and a prospective study was carried out. Altogether 144 patients were tested for the presence of IEA, before as well as after obtaining frozen allogeneic bone in orthopedic or maxillo-facial surgery. In 9 patients, the tests disclosed IEA preoperatively. No new IEA were detected postoperatively in the 144 patients, including 30 Rh(D) negative patients who received Rh(D) positive bone. We conclude that formation of IEA is a rare phenomenon. Nevertheless, it is recommended to give only Rh(D) negative bone to Rh(D) negative girls and women of childbearing age.