Premium
Red‐blood‐cell alloimmunization and prophylactic antigen matching for transfusion in patients with warm autoantibodies
Author(s) -
Delaney Meghan,
Apelseth Torunn Oveland,
Bonet Bub Carolina,
Cohn Claudia S.,
Dunbar Nancy M.,
Mauro Kutner Jose,
Murphy Michael,
Perelman Iris,
Selleng Kathleen,
Staves Julie,
Wendel Silvano,
Ziman Alyssa
Publication year - 2020
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/vox.12914
Subject(s) - medicine , haemolysis , serology , autoantibody , antigen , antibody , red blood cell , blood transfusion , red cell , immunology , isoantibodies
Background Warm autoantibodies (WAA) are antibodies that react with an antigen on a patient’s own red‐blood‐cells and can complicate compatibility testing whether or not they cause clinical haemolysis. The goal of this study was to understand the overall prevalence of WAA, the risk of RBC alloimmunization and determine whether RBC selection practices have an impact on alloimmunization. Materials and methods Records of patients (>1 year of age) with an indirect antibody detection test (IAT) and serologic evidence of WAA over a 10‐year‐period were included. Eight centres from 5 countries collectively reviewed 1 122 245 patients who had an IAT. Results Of patients having IAT, 1214 had WAA (0·17%). Transfusion information for 1002 of the patients was available; 631 were transfused after identification of the WAA (63%); of the transfused patients, 390 received prophylactic antigen‐matched (PAM) RBCs and 241 did not. Of the 372 patients with WAA who were transfused and had serologic testing 30+ days following transfusion (30–2765 days), 56 developed new RBC alloimmunization (15·1%). Patients who were transfused using a PAM strategy were not protected from new RBC alloimmunization [14·6% (31 of 212 patients) having PAM transfusion approach compared with those not receiving PAM approach (15·6%, 25 of 160 patients, P = 0·8837)]. Conclusions The prevalence of WAA in patients having an IAT is low (<1%). A significant portion of patients with WAA form new RBC alloimmunization (15·1%); however, the use of PAM approach for RBC selection was not found to be protective against new alloimmunization.