Case report: immune anti-D stimulated by transfusion of fresh frozen plasma

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Immunohematology

American National Red Cross

Subject: Medical Laboratory Technology

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ISSN: 0894-203X
eISSN: 1930-3955

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VOLUME 21 , ISSUE 4 (December 2005) > List of articles

Case report: immune anti-D stimulated by transfusion of fresh frozen plasma

Marian Connolly / Wendy N. Erber / Dianne E. Grey

Keywords : red blood cell, antibody, anti-D, contamination, fresh frozen plasma, FFP

Citation Information : Immunohematology. Volume 21, Issue 4, Pages 149-151, DOI: https://doi.org/10.21307/immunohematology-2019-410

License : (Transfer of Copyright)

Published Online: 28-April-2020

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ABSTRACT

FFP has occasionally been reported to generate an immune response to RBC antigens (e.g.,anti-D and anti-Fya). The Council of Europe requires that each unit of FFP have less than 6 ×109/L RBCs. However, there is considerable variation internationally in the method of production and the level and assessment of RBC contamination of FFP . This study reports the case of a 63-year-old group B, D– man who received multiple transfusions of D– blood products over a 4-month period. Seven months later the patient’s antibody screen remained negative and he was transfused with seven units of D– RBCs and six units of FFP,four of which were D+. Two months later anti-D, -E, and -K were detected in his plasma. Although the anti-E and anti-K could have resulted from transfusion of antigen-positive RBCs, the anti-D could have resulted only from transfusion of the D+ FFP . The D status of FFP is currently not considered when selecting products for transfusion even though the D antigen is highly immunogenic and the level of RBC contamination of FFP is not always known. This case highlights that transfusion of FFP is a stimulus for RBC antibodies and that when a patient has had a recent transfusion of FFP,consideration should be given to obtaining a sample for pretransfusion testing within 3 days before a scheduled RBC transfusion. In addition,the D status of FFP should be considered before administering FFP to premenopausal D– women.

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