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Absence of D– alloimmunization in AIDS patients receiving D‐mismatched RBCs
Author(s) -
Boctor Fouad N.,
Ali Nahed M.,
Mohandas Kala,
Uehlinger Joan
Publication year - 2003
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.2003.00289.x
Subject(s) - medicine , abo blood group system , blood transfusion , anemia , economic shortage , antibody , immunology , surgery , linguistics , philosophy , government (linguistics)
BACKGROUND: More than 80 percent of D– patients who receive D+ blood become alloimmunized to the D antigen. Anemia occurs in most AIDS patients at some point in the disease. D– patients with AIDS may require blood transfusion and, during times of blood shortage, may receive D+ RBCs. They would be expected to become alloimmunized to thed antigen. STUDY DESIGN AND METHODS : The records of the transfusion service between January 1996 and July 2000 were reviewed for D– patients who received D+ blood. IATs were performed before the initial transfusion and subsequently when the patient required further RBC transfusion. RESULTS : Eight D– AIDS patients who received multiple transfusions (three women and five men; age range, 31‐44 years; mean, 44 years) who received between 2 and 11 units (mean, 6.25) of D+ RBCs were identified. Antibody screens were performed at 8 to 65 weeks after transfusion. It was found that none of the eight D– AIDS patients developed anti‐D. ABO antibodies were found as expected. During the same period, it was found that six D– patients admitted with other diagnoses who received 1 to 9 units of D+ RBCs, all developed anti‐D within 7 to 19 weeks of transfusion. CONCLUSION : Patients with AIDS may not form alloantibodies to the D antigen. This may be attributable to their immunodepressed state, particularly to the decrease in CD4+ T lymphocytes. Therefore, during blood shortages, transfusion of D+ blood to D– AIDS patients may be without any subsequent consequence.