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Prevalence and risk factors for RBC alloantibodies in blood donors in the Recipient Epidemiology and Donor Evaluation Study‐III (REDS‐III)
Author(s) -
Karafin Matthew S.,
Tan Sylvia,
Tormey Christopher A.,
Spencer Bryan R.,
Hauser Ronald G.,
Norris Philip J.,
Roubinian Nareg H.,
Wu Yanyun,
Triulzi Darrell J.,
Kleinman Steve,
Gottschall Jerome L.,
Hendrickson Jeanne E.
Publication year - 2019
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.15004
Subject(s) - epidemiology , blood donor , medicine , immunology
BACKGROUND Little information exists on red blood cell (RBC) alloimmunization in healthy US blood donors, despite the potential significance for donors themselves, blood recipients, and the blood center. STUDY DESIGN AND METHODS Donor/donation data were sourced from the Recipient Epidemiology and Donor Evaluation Study‐III, which contains information from four US blood centers during 2012 through 2016. Multivariable logistic regression was used to assess prevalence of positive antibody screen by donor demographics, blood type, parity, and transfusion history. RESULTS More than 2 million units were collected from 632,378 donors, with 0.51% of donations antibody screen positive and 0.77% of donors having at least one positive antibody screen. The most common antibody specificities were D (26.4%), E (23.8%), and K (21.6%). Regression analysis indicated that increasing age, female sex, D‐negative status, and history of transfusion and pregnancy were positively associated with a positive antibody screen. Prior transfusion history was most strongly associated with a positive antibody screen, with donors reporting a prior transfusion having a higher adjusted odds ratio (3.9) of having a positive antibody screen compared to donors reporting prior pregnancy (adjusted odds ratio, 2.0). Though transfusion was a more potent immune stimulus for RBC alloantibody formation than pregnancy, the sheer number of previously pregnant donors contributed to pregnancy being a risk factor for the majority of clinically significant RBC alloantibodies detected in females. CONCLUSION These findings on prevalence of and risk factors for RBC antibodies may have implications for future medical care of donors and for operations at blood centers.