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Blood transfusion in the para‐Bombay phenotype
Author(s) -
LinChu M.,
Broadberry R. E.
Publication year - 1990
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1990.tb07800.x
Subject(s) - phenotype , blood transfusion , medicine , transfusion medicine , hematology , intensive care medicine , immunology , biology , genetics , gene
S ummary . The H‐deficient phenotypes found in Chinese so far, have all been secretors of soluble blood group substances in saliva. The corresponding isoagglutinin activity (e.g. anti‐B in O B Hm persons) has been found to be weak in all cases. To determine the clinical significance of these weak isoagglutinins 51 Cr red cell survival tests were performed on three O B Hm individuals transfused with small volumes (4 ml) of groups B and O RBC. Rapid destruction of most of the RBC occurred whether or not the isoagglutinins of the O B Hm individuals were indirect antiglobulin test (IAGT) reactive. When a larger volume (54 ml packed RBC) of group B cells (weakly incompatible by IAGT) was transfused to another O B Hm individual with IAGT active anti‐HI, the survival of the transfused RBC was 93% at 24 h, with 30% of the RBC remaining in the circulation at 28 d in contrast to 76% as would be expected if the survival was normal. Therefore when whole units of blood of normal ABO blood groups, compatible by IAGT, are transfused, the survival is expected to be almost normal. These weak isoagglutinins may not be very clinically significant and we suggest that when para‐Bombay blood is not available, the compatibility testing for O A Hm persons should be performed with group A and group O B Hm packed RBC; O B Hm with group B and group O packed RBC; O AB Hm with groups A, B, AB and O packed RBC. For cross matching, the indirect antiglobulin test by a prewarmed technique should be used.