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Provision of KEL 1‐negative blood to obstetric patients: a 3‐year single‐institution retrospective review
Author(s) -
O'Brien Kerry L.,
Kim Yeowon A.,
Haspel Richard L.,
Uhl Lynne
Publication year - 2015
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12814
Subject(s) - medicine , obstetrics , gestational age , pregnancy , blood transfusion , obstetric history , fetus , pediatrics , retrospective cohort study , gestation , immunology , surgery , genetics , biology
Background KEL 1 alloimmunization is a major cause of hemolytic disease of the fetus and newborn ( HDFN ). While select countries have guidelines for preventing transfusion‐associated KEL 1 alloimmunization, the U nited S tates does not. B eth I srael D eaconess M edical C enter instituted a policy in A pril 2009 whereby women not more than 50 years of age on the obstetric service were transfused KEL 1‐negative red blood cells ( RBC s). We sought to determine compliance and impact for prevention of KEL 1 alloimmunization and HDFN . Study Design and Methods All women not more than 50 years of age without anti‐ K transfused RBC s during an obstetric admission from A pril 9, 2009, to A pril 9, 2012, were identified (227). Adherence to policy, factors contributing to nonadherence, and subsequent impact were evaluated. For comparison, all cases of anti‐ K detection in women not more than 50 years of age admitted to nonobstetric services and all cases of transfusion‐associated KEL 1 alloimmunization in women not more than 50 years of age during the 10 years prior were identified. Results Eighty‐four percent received only KEL 1‐negative units. Three (1.3%) women not more than 50 years of age on the obstetric service were identified with anti‐ K , while 17 (1.5%) women not more than 50 years of age on nonobstetric services had anti‐ K detected; only five of 20 had a prior RBC transfusion. In the 10 years prior, there were 27 cases of transfusion‐associated KEL 1 alloimmunization in women not more than 50 years of age. There were no cases of KEL 1 HDFN in either period. Conclusion Although the findings demonstrate feasibility of providing KEL 1‐negative RBC s to women of childbearing potential, evidence for clinical benefit is lacking. The low prevalence of KEL 1 in blood donors, the lack of significant differences in alloimmunization rates, and no cases of HDFN during the study period questions the clinical benefit of such a policy.