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Erschienen in: Indian Journal of Hematology and Blood Transfusion 3/2022

20.02.2022 | Original Article

Anti-D Alloimmunization After RhD Positive Red Cell Transfusion to Selected RhD Negative Patients

verfasst von: Prashant Pandey, Divya Setya, Mukesh Kumar Singh

Erschienen in: Indian Journal of Hematology and Blood Transfusion | Ausgabe 3/2022

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Abstract

Transfusion of RhD positive red cells to RhD negative individuals is not routine transfusion practice for the fear of alloimmunization. Aim of this study was to prospectively evaluate rate of alloimmunization after transfusion of RhD positive red cells in RhD negative individuals and to assess delay in transfusion due to decision making. This was a prospective, observational study conducted from 2014 to 2018. All patients were followed up for a period of three months, at 3, 14, 45 and 90 days with antibody screening. In addition, patients who were immunosuppressed and alloimmunized were followed up at 6 months and one year. During the period of the study, there were a total of 57 RhD negative patients (52 males and five females) who received a mean of 4.42 ± 2.85 transfusions. Alloimmunization was detected in 8 (14.03%) patients at a mean interval of 25.63 ± 16.04 days. Anti-D was detected in seven and one patient developed anti-E alloantibody. Mean number of red cell units transfused in alloimmunized was 1.7 ± 0.26 while it was 5.4 ± 1.82 in non-alloimmunized group. There was no delay in providing units to these patients. The TAT was found to be 68 min. Rate of alloimmunization after transfusion of RhD positive red cells to RhD negative individuals was found to be 12.3%. In life saving conditions, RhD negative patients can be transfused RhD positive red cells without delay in decision making.
Literatur
1.
Zurück zum Zitat Hunt BJ, Allard S, Keeling D, Norfolk D, Stanworth SJ, Pendry K (2015) British committee for standards in haematology. A practical guideline for the haematological management of major haemorrhage. Br J. Haematol 170(6):788–803 CrossRef Hunt BJ, Allard S, Keeling D, Norfolk D, Stanworth SJ, Pendry K (2015) British committee for standards in haematology. A practical guideline for the haematological management of major haemorrhage. Br J. Haematol 170(6):788–803 CrossRef
2.
Zurück zum Zitat National Blood Transfusion Committee (2016) A plan for NHS blood and transplant and hospitals to address red cell shortages. National Blood Transfusion Committee National Blood Transfusion Committee (2016) A plan for NHS blood and transplant and hospitals to address red cell shortages. National Blood Transfusion Committee
3.
Zurück zum Zitat Selleng K, Jenichen G, Denker K, Selleng S, Müllejans B, Greinacher A (2017) Emergency transfusion of patients with unknown blood type with blood group O Rhesus D positive red blood cell concentrates: a prospective, single-centre, observational study. Lancet Haematol 4(5):e218–e224 CrossRef Selleng K, Jenichen G, Denker K, Selleng S, Müllejans B, Greinacher A (2017) Emergency transfusion of patients with unknown blood type with blood group O Rhesus D positive red blood cell concentrates: a prospective, single-centre, observational study. Lancet Haematol 4(5):e218–e224 CrossRef
4.
Zurück zum Zitat Flommersfeld S, Mand C, Kühne CA, Bein G, Ruchholtz S, Sachs UJ (2018) Unmatched type O RhD+ red blood cells in multiple injured patients. Transfus Med Hemother 45(3):158–161 CrossRef Flommersfeld S, Mand C, Kühne CA, Bein G, Ruchholtz S, Sachs UJ (2018) Unmatched type O RhD+ red blood cells in multiple injured patients. Transfus Med Hemother 45(3):158–161 CrossRef
5.
Zurück zum Zitat Murphy M, BenAvram D (2019) Recommendations on the use of group O red blood cells. AABB Assoc Bull 2019:19–02 Murphy M, BenAvram D (2019) Recommendations on the use of group O red blood cells. AABB Assoc Bull 2019:19–02
6.
Zurück zum Zitat Pollack W, Ascari WQ, Crispen JF, O’Connor RR, Ho TY (1971) Studies on Rh prophylaxis. II. Rh immune prophylaxis after transfusion with Rh-positive blood. Transfusion 11:340–4 CrossRef Pollack W, Ascari WQ, Crispen JF, O’Connor RR, Ho TY (1971) Studies on Rh prophylaxis. II. Rh immune prophylaxis after transfusion with Rh-positive blood. Transfusion 11:340–4 CrossRef
7.
Zurück zum Zitat Ramsey G, Hahn LF, Cornell FW, Boczkowski DJ, Staschak S, Clark R, Hardesty RL, Griffith BP, Starzl TE (1989) Low rate of Rhesus immunization from Rh-incompatible blood transfusions during liver and heart transplant surgery. Transplantation 47:993–995 CrossRef Ramsey G, Hahn LF, Cornell FW, Boczkowski DJ, Staschak S, Clark R, Hardesty RL, Griffith BP, Starzl TE (1989) Low rate of Rhesus immunization from Rh-incompatible blood transfusions during liver and heart transplant surgery. Transplantation 47:993–995 CrossRef
8.
Zurück zum Zitat Abou-Elella AA, Camarillo TA, Allen MB, Barclay S, Pierce JA, Holland HK, Wingard JR, Bray RA, Rodey GE, Hillyer CD (1995) Low incidence of red cell and HLA antibody formation by bone marrow transplant patients. Transfusion 35:931–935 CrossRef Abou-Elella AA, Camarillo TA, Allen MB, Barclay S, Pierce JA, Holland HK, Wingard JR, Bray RA, Rodey GE, Hillyer CD (1995) Low incidence of red cell and HLA antibody formation by bone marrow transplant patients. Transfusion 35:931–935 CrossRef
9.
Zurück zum Zitat Asfour M, Narvios A, Lichtiger B (2004) Transfusion of RhD incompatible blood components in RhD-negative blood marrow transplant recipients. Med Gen Med 6:22 Asfour M, Narvios A, Lichtiger B (2004) Transfusion of RhD incompatible blood components in RhD-negative blood marrow transplant recipients. Med Gen Med 6:22
10.
Zurück zum Zitat Schonewille H, Haak HL, van Zijl AM (1999) Alloimmunization after blood transfusion in patients with hematologic and oncologic diseases. Transfusion 39:763–771 CrossRef Schonewille H, Haak HL, van Zijl AM (1999) Alloimmunization after blood transfusion in patients with hematologic and oncologic diseases. Transfusion 39:763–771 CrossRef
11.
Zurück zum Zitat Boctor FN, Ali NM, Mohandas K, Uehlinger J (2003) Absence of D-alloimmunization in AIDS patients receiving D-mismatched RBCs. Transfusion 43:173–176 CrossRef Boctor FN, Ali NM, Mohandas K, Uehlinger J (2003) Absence of D-alloimmunization in AIDS patients receiving D-mismatched RBCs. Transfusion 43:173–176 CrossRef
12.
Zurück zum Zitat Frohn C, Dümbgen L, Brand JM, Gorg S, Luhm J, Kirchner H (2003) Probability of anti-D development in D- patients receiving D+ RBCs. Transfusion 43:893–898 CrossRef Frohn C, Dümbgen L, Brand JM, Gorg S, Luhm J, Kirchner H (2003) Probability of anti-D development in D- patients receiving D+ RBCs. Transfusion 43:893–898 CrossRef
13.
Zurück zum Zitat Yazer MH, Triulzi DJ (2007) Detection of anti-D in D-recipients transfused with D+ red blood cells. Transfusion 47:2197–2201 CrossRef Yazer MH, Triulzi DJ (2007) Detection of anti-D in D-recipients transfused with D+ red blood cells. Transfusion 47:2197–2201 CrossRef
14.
Zurück zum Zitat Urbaniak SJ (2006) Alloimmunity to RhD in humans. Transfus Clin Biol 3(1–2):19–22 CrossRef Urbaniak SJ (2006) Alloimmunity to RhD in humans. Transfus Clin Biol 3(1–2):19–22 CrossRef
15.
Zurück zum Zitat Moise KJ (2005) Red blood cell alloimmunization in pregnancy. Semin Hematol 42:169–178 CrossRef Moise KJ (2005) Red blood cell alloimmunization in pregnancy. Semin Hematol 42:169–178 CrossRef
16.
Zurück zum Zitat Gonzalez-Porras JR, Graciani IF, Perez-Simon JA, Martin-Sanchez J, Encinas C, Conde MP, Nieto MJ, Corral M (2008) Prospective evaluation of a transfusion policy of D+ red blood cells into D− patients. Transfusion 48:1318–1324 CrossRef Gonzalez-Porras JR, Graciani IF, Perez-Simon JA, Martin-Sanchez J, Encinas C, Conde MP, Nieto MJ, Corral M (2008) Prospective evaluation of a transfusion policy of D+ red blood cells into D− patients. Transfusion 48:1318–1324 CrossRef
17.
Zurück zum Zitat Baldwin ML, Ness PM, Scott D, Braine H, Kickler TS (1988) Alloimmunization to D antigen and HLA in D- immunosuppressed oncology patients. Transfusion 28:330–333 CrossRef Baldwin ML, Ness PM, Scott D, Braine H, Kickler TS (1988) Alloimmunization to D antigen and HLA in D- immunosuppressed oncology patients. Transfusion 28:330–333 CrossRef
18.
Zurück zum Zitat Casanueva M, Valdes MD, Ribera MC (1994) Lack of alloimmunization to D antigen in D-negative immunosuppressed liver transplant recipients. Transfusion 34(7):570–572 CrossRef Casanueva M, Valdes MD, Ribera MC (1994) Lack of alloimmunization to D antigen in D-negative immunosuppressed liver transplant recipients. Transfusion 34(7):570–572 CrossRef
19.
Zurück zum Zitat Lozano M, Cid J (2003) The clinical implications of platelet transfusions associated with ABO or Rh(D) incompatibility. Transfus Med Rev 17:57–68 CrossRef Lozano M, Cid J (2003) The clinical implications of platelet transfusions associated with ABO or Rh(D) incompatibility. Transfus Med Rev 17:57–68 CrossRef
20.
Zurück zum Zitat Williams LA III, Sikora J, Aldrees R, Pham HP, Marques MB (2019) Anti-Rh alloimmunization after trauma resuscitation. Transfus Apheresis Sci 58(6):102652 CrossRef Williams LA III, Sikora J, Aldrees R, Pham HP, Marques MB (2019) Anti-Rh alloimmunization after trauma resuscitation. Transfus Apheresis Sci 58(6):102652 CrossRef
21.
Zurück zum Zitat Dara RC, Tiwari AK, Arora D, Aggarwal G, Acharya D, Raina V (2015) Practice of transfusing D-positive platelets in D-negative recipients–a reappraisal (POINT-R). ISBT Sci Ser 10(2):87–92 CrossRef Dara RC, Tiwari AK, Arora D, Aggarwal G, Acharya D, Raina V (2015) Practice of transfusing D-positive platelets in D-negative recipients–a reappraisal (POINT-R). ISBT Sci Ser 10(2):87–92 CrossRef
22.
Zurück zum Zitat Asfour M, Narvios A, Lichtiger B (2004) Transfusion of RhD-incompatible blood components in RhD-negative blood marrow transplant recipients. Med Gen Med 6(3):2 Asfour M, Narvios A, Lichtiger B (2004) Transfusion of RhD-incompatible blood components in RhD-negative blood marrow transplant recipients. Med Gen Med 6(3):2
23.
Zurück zum Zitat Agarwal N, Chandola I, Agarwal A (2013) Prevalence of weak D in northern hilly areas of Uttarakhand. India Asian J Transfus Sci 7(1):90–91 CrossRef Agarwal N, Chandola I, Agarwal A (2013) Prevalence of weak D in northern hilly areas of Uttarakhand. India Asian J Transfus Sci 7(1):90–91 CrossRef
24.
Zurück zum Zitat Gundrajukuppam DK, Vijaya SB, Rajendran A, Sarella JD (2014) Prevalence of ABO and Rhesus blood groups in blood donors. J Clin Diagn Res 8(12):7–10 Gundrajukuppam DK, Vijaya SB, Rajendran A, Sarella JD (2014) Prevalence of ABO and Rhesus blood groups in blood donors. J Clin Diagn Res 8(12):7–10
25.
Zurück zum Zitat Agarwal N, Thapliyal RM, Chatterjee K (2013) Blood group phenotype frequencies in blood donors from a tertiary care hospital in North India. Blood Res 48:2 CrossRef Agarwal N, Thapliyal RM, Chatterjee K (2013) Blood group phenotype frequencies in blood donors from a tertiary care hospital in North India. Blood Res 48:2 CrossRef
26.
Zurück zum Zitat Setya D, Tiwari AK, Arora D, Mitra S, Mehta SP, Aggarwal G (2020) The frequent and the unusual red cell phenotypes in Indian blood donors: a quest for rare donors. Transfus Apheresis Sci 59(4):102765 CrossRef Setya D, Tiwari AK, Arora D, Mitra S, Mehta SP, Aggarwal G (2020) The frequent and the unusual red cell phenotypes in Indian blood donors: a quest for rare donors. Transfus Apheresis Sci 59(4):102765 CrossRef
27.
Zurück zum Zitat Ayache S, Herman JH (2008) Prevention of D sensitization after mismatched transfusion of blood components: toward optimal use of RhIG. Transfusion 48(9):1990–1999 CrossRef Ayache S, Herman JH (2008) Prevention of D sensitization after mismatched transfusion of blood components: toward optimal use of RhIG. Transfusion 48(9):1990–1999 CrossRef
28.
Zurück zum Zitat Ahsan BU, Wlosinski L, El-Bashir J, Nagai S, Yoshida A, Abouljoud M, Otrock ZK (2019) Lack of alloimmunization to the D antigen in D-liver transplant recipients receiving D+ RBCs perioperatively Ahsan BU, Wlosinski L, El-Bashir J, Nagai S, Yoshida A, Abouljoud M, Otrock ZK (2019) Lack of alloimmunization to the D antigen in D-liver transplant recipients receiving D+ RBCs perioperatively
29.
Zurück zum Zitat Uzuni A, Nagai S, Yoshida A, Abouljoud MS, Otrock ZK (2019) Transfusion requirements and immunohematologic complications in orthotopic liver transplantation 218A Uzuni A, Nagai S, Yoshida A, Abouljoud MS, Otrock ZK (2019) Transfusion requirements and immunohematologic complications in orthotopic liver transplantation 218A
30.
Zurück zum Zitat Pahuja S, Pujani M, Gupta SK, Chandra J, Jain M (2010) Alloimmunization and red cell autoimmunization in multitransfused thalassemics of Indian origin. Hematology 15(3):174–177 CrossRef Pahuja S, Pujani M, Gupta SK, Chandra J, Jain M (2010) Alloimmunization and red cell autoimmunization in multitransfused thalassemics of Indian origin. Hematology 15(3):174–177 CrossRef
31.
Zurück zum Zitat Sood R, Makroo RN, Riana V, Rosamma NL (2013) Detection of alloimmunization to ensure safer transfusion practice. Asian J Transfus Sci 7(2):135 CrossRef Sood R, Makroo RN, Riana V, Rosamma NL (2013) Detection of alloimmunization to ensure safer transfusion practice. Asian J Transfus Sci 7(2):135 CrossRef
32.
Zurück zum Zitat Chapman JF, Forman K, Kelsey P, Knowles SM, Murphy MF, Wood JK, Chapman JF, Baglin T, Knowles SM, Milkins CE, Poole G (1996) Guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories. Transfus Med 6(3):273–283 CrossRef Chapman JF, Forman K, Kelsey P, Knowles SM, Murphy MF, Wood JK, Chapman JF, Baglin T, Knowles SM, Milkins CE, Poole G (1996) Guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories. Transfus Med 6(3):273–283 CrossRef
Metadaten
Titel
Anti-D Alloimmunization After RhD Positive Red Cell Transfusion to Selected RhD Negative Patients
verfasst von
Prashant Pandey
Divya Setya
Mukesh Kumar Singh
Publikationsdatum
20.02.2022
Verlag
Springer India
Erschienen in
Indian Journal of Hematology and Blood Transfusion / Ausgabe 3/2022
Print ISSN: 0971-4502
Elektronische ISSN: 0974-0449
DOI
https://doi.org/10.1007/s12288-021-01506-w