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  • Immunohematology


Article | 17-February-2021

K antigens on neonatal red blood cells blocked by anti-K with titer of 32

Kell blood group system is very polymorphic, with 35 antigens assigned to the system,1 encoded by the KEL gene, with K and k being the most common antigens. K is completely expressed on fetal RBCs by the 10th gestational week. The total number of K antigen sites per RBC is quite low, but despite its lower quantity, K is very immunogenic.2 Anti-K is the third most common specificity of RBC alloantibody involved in causing HDFN, with the first being naturally occurring ABO, followed by immune anti-D

J. Novoselac, M. Raos, G. Tomac, M. Lukić, B. Golubić Ćepulić

Immunohematology, Volume 36 , ISSUE 2, 54–57

Article | 18-October-2020

Comparison of tube and gel techniques for antibody identification

specificity by both methods. One hundred and ninety-six were reactive only by gel: 25 anti-D, 33 anti-C, 76 anti-E, 13 anti-c, 5 anti-e, 18 anti-K, 7 anti-Jka, 2 anti-Dia, 3 anti-S, 8 combination Rh antibodies (1 with antiK), and 6 other antibody specificities. Two samples were reactive only by PEG-IAT: 1 anti-K and 1 anti-Dia. Four hundred and thirty were positive by the two methods: 156 anti-D, 9 anti-C, 68 anti-E, 15 anti-c, 6 anti-e, 61 anti-K, 12 anti-Jka, 17 anti-Dia, 5 anti-S, 73 combination Rh

Marcia Cristina Zago Novaretti, Eduardo Jens Silveira, Edio da Costa Filho, Pedro Enrique Dorlhiac- Llacer, Dalton de Alencar Fischer Chamone

Immunohematology, Volume 16 , ISSUE 4, 138–141

Case report | 01-December-2019

Possible suppression of fetal erythropoiesis by the Kell blood group antibody anti-Kpa

Antibodies to antigens in the Kell blood group system are usually immunoglobulin G, and, notoriously, anti-K, anti-k, and anti-Kpa can cause severe hemolytic transfusion reactions, as well as severe hemolytic disease of the fetus and newborn (HDFN). It has been shown that the titer of anti-K does not correlate with the severity of HDFN because, in addition to immune destruction of red blood cells (RBCs), anti-K causes suppression of erythropoiesis in the fetus, which can result in severe anemia

Michelle Tuson, Kim Hue-Roye, Karen Koval, Sherwin Imlay, Rajendra Desai, Gayatri Garg, Esam Kazem, Diane Stockman, Janis S. Hamilton, Marion E. Reid

Immunohematology, Volume 27 , ISSUE 2, 58–60

Article | 28-April-2020

Autoimmune hemolytic anemia and a further example of autoanti-Kpb

A 65-year-old Caucasian man with myelodysplasia was admitted with autoimmune hemolytic anemia and a Hb of 5.6 g/dL. The patient’s serum contained anti-K; the DAT on the patient’s RBCs reacted 3+ with anti-IgG and 3+ with anti-C3d.K– RBC units were transfused, but there was no sustained increase in Hb level. The samples were referred to the reference laboratory of the National Blood Service. The DAT results remained the same, with anti-K detected only in the serum. An eluate

Edmond Lee, Gordon Burgess, Nay Win

Immunohematology, Volume 21 , ISSUE 3, 119–121

Report | 01-December-2019

Single-center comparison of gel microcolumn and solid-phase methods for antibody screening

Anne Schmidt, Brenda J. Bendix, Eapen K. Jacob, Sandra C. Bryant, James R. Stubbs

Immunohematology, Volume 29 , ISSUE 3, 101–104

Letter | 14-October-2020

Letter to the Editors: A hemolytic transfusion reaction due to anti-K undetected by a LISS antibody screen

Mark T. Friedman, Alan P. Carioti

Immunohematology, Volume 17 , ISSUE 3, 90–91

Article | 14-October-2020

MIMA-9, a valuable antibody for screening for rare donors

Edith Tossas, Ragnhild Øyen, Gregory R. Halverson, Harry Malyska, Marion E. Reid

Immunohematology, Volume 18 , ISSUE 2, 43–45

Article | 16-November-2020

A method to detect McLeod phenotype red blood cells

flow cytometry (control cells 441). Monoclonal anti-k (F7) and human polyclonal anti-k (C30A-1) gave stronger reactions by hemagglutination with RBCs from McLeod males and were not appropriate to differentiate RBCs with the McLeod phenotype from RBCs with normal Kell antigen expression. Crisp mixed-field agglutination was obtained in tests with monoclonal anti-K14 versus RBCs from the 12 obligate carrier females. Flow cytometry using anti-K14 also clearly identified two RBC populations (median

Ragnhild Øyen, Marion E. Reid, Pablo Rubinstein, Harold Ralph

Immunohematology, Volume 12 , ISSUE 4, 160–163

Article | 17-November-2020

A comparison of two solid phase systems for antibody detection

samples. The sensitivity and specificity of CR, based on the 96 previously screened samples, was 95 percent and 90 percent, respectively, and the sensitivity and specificity of RS was 90 percent and 89 percent, respectively. Antibodies detected only by CR included anti-K(1), -Ch(2), -Jka(1), -Lea(1), -Fya(1), -Mca(1), and -e(1). Antibodies detected only by RS included anti-Jka(5) and -E(1). The sensitivity and specificity of CR for the 648 prenatal samples was 100 percent for each, while the

Gwen M. Haslam, Margaret Persaud, Yvette Fournier, Joanne Sajur, Janice Aulph, Nancy Heddle

Immunohematology, Volume 11 , ISSUE 1, 8–10

Article | 03-November-2020

K phenotyping using a PK-7200 automated analyzer

K (Kell) is one of the most immunogenic of the red blood cell (RBC) antigens. In order to select K− RBC units, we developed K phenotyping on the Olympus PK-7200 equipment to save labor, time, and costs. The Olympus PK-7200 is fully automated equipment used primarily for blood typing and syphilis screening. We tested 3,587 blood donor samples in EDTA using a commercial anti-K serum diluted in HP Hemagen Power SolutionR(1:40). The equipment was set to prepare a 1.7% RBC suspension in

Marcia C. Zago-Novaretti, Silvana P. Navarro, Pedro E. Dorlhiac-Llacer, Dalton A.F. Chamone

Immunohematology, Volume 14 , ISSUE 1, 22–25

Article | 17-November-2020

Analysis ofthe routine use of polyethylene glycol (PEG) as an enhancement medium

) involving an anti-K that was not detected with LISS but was retrospectively found to be reactive with PEG, an additional 151 samples received for antibody screening were prospectively evaluated in parallel using PEG and LISS. PEG detected all clinically significant antibodies in the 50 previously tested samples, with mean reactivity scores greater than LISS or A-IAT. In the prospective study, PEG detected 35 clinically significant antibodies and 10 clinically insignificant antibodies, while LISS

Vicki J. Barrett, James R. Stubbs, Karen Stuardi, Angela Hollis, Leslie Clear

Immunohematology, Volume 11 , ISSUE 1, 11–13

Article | 14-December-2020

Primary immune response to blood group antigens in burned children

positive direct antiglobulin test (DAT), or both. None of the 11 patients included in the study had been previously tranfused or pregnant. The average number of units transfused prior to antibody identification was 19. The average time elapsed between the first transfusion and antibody identification was 3.6 weeks. Anti-K and anti-E were the most frequently identified. Three patients had a decrease in hemoglobin (average 1.5 g/dL) and hematocrit at the time that a positive DAT was detected. Such

Nancy E. Bacon, Ethel D. Patten, Janet L. Vincent

Immunohematology, Volume 7 , ISSUE 1, 8–11

Report | 12-March-2020

Determination of optimal method for antibody identification in a reference laboratory

autoantibodies, respectively. Solid-phase testing failed to detect 12 examples of anti-K. No identifiable pattern of reactivity was found in 13 samples using gel testing compared with 6 for solid-phase and none for tube methodologies. Hemagglutination tube method was the best choice for our IRL because it missed the fewest number of clinically significant alloantibodies. Benefits also included the ability to use various potentiating factors, incubation times, and temperature phases to enhance antibody

Jennifer R. Haywood, Marilyn K. Grandstaff Moulds, Barbara J. Bryant

Immunohematology, Volume 27 , ISSUE 4, 146–150

Article | 09-November-2020

The use of polyethylene glycol (PEG) to enhance the adsorption of autoantibodies

specificities (anti-K, anti-Jkb), known to be present in the serum, were not detected in the PEG tests. Four specificities were weaker with the PEG adsorbed serum. All other alloantibody specificities (13) were detected with equal or greater strength in the PEG adsorbed serum. The use of PEG to enhance the adsorption of autoantibodies should be considered as an option to reduce the time and cost of labor-intensive differential adsorptions. Laboratories should be cautioned that weak alloantibodies may not be

Christina L. Barron, Mary Beth Brown

Immunohematology, Volume 13 , ISSUE 4, 119–122

Case report | 28-April-2020

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

. 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

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

Immunohematology, Volume 21 , ISSUE 4, 149–151

Article | 09-November-2020

The gel test: sensitivity and specificity for unexpected antibodies to blood group antigens

of these (cold auto, anti-M, -Le, etc.) were considered harmless with respect to transfusion management. GEL–LISS+ tests included seven samples containing potentially significant antibodies (assumed from specificity): anti-K(4), -Jka, -Fyb, and -S. Two potentially significant antibodies (antiC and -D) were GEL+LISS–. Sensitivity and specificity for potentially significant antibodies were 92% and 96% for GEL, and 98% and 90% for LISS, respectively. The seven GEL–LISS+ samples

W. John Judd, E. Ann Steiner, Pamela C. Knaf

Immunohematology, Volume 13 , ISSUE 4, 132–135

Article | 06-December-2020

Failure to detect a prozoning anti-Fya in the serum of a chronically transfused patient

facility for acute hemorrhage. Only the presence of anti-JH in the serum was documented. To detect possible immune red cell destruction, the patient was monitored by our facility at 24-hour intervals with a direct antiglobulin test and antibody screen. On day 4, a 4+ anti-Fya was identified in the serum and the DAT was negative. Three days later anti-K was also identified. The serologic picture remained unchanged for 10 days, when the DAT became positive. Concurrently, a mixed-field Fya typing (on the

Jody C. Sizemore, Teresa D. Sammons, Jerry N. Clanton

Immunohematology, Volume 8 , ISSUE 2, 44–46

Article | 15-April-2020

Efficacy of murine monoclonal antibodies in RBC phenotyping of DAT-positive samples

method. There are a limited number of direct agglutinating monoclonal antibodies available. Murine monoclonal antibodies provide an additional tool for typing RBCs with a positive DAT. Five murine monoclonal IgG antibodies (anti-K: MIMA-22, MIMA-23; anti-Kpa: MIMA-21, MIMA-27; anti-Fya: MIMA-19) were used in this study. Donor RBCs with known phenotypes were sensitized in vitro with alloanti-D, alloanti-c, and alloanti-K and with 20 autoantibodies (autoanti-D [n=3],autoanti-e [n=5], autoanti-Ce/e [n=5

Edmond Lee, Kevin Hart, Gordon Burgess, Gregory R. Halverson, Marion E. Reid

Immunohematology, Volume 22 , ISSUE 4, 161–165

Article | 22-January-2021

Routine indirect antiglobulin testing of blood donors—a further step toward blood safety: an experience from a tertiary care center in northern India

%] in 3 of the 19 alloimmunized donors), followed by those of the MNS blood group system (3 of 25 [12%] in 2 of 19 alloimmunized donors). Anti-K was found in one donor (1 of 25 [4%]). The majority (79%) of alloimmunized donors were D+ (15 of 19; alloimmunization rate 15 of 9779, 0.15%), and 21 percent (4 of 19; alloimmunization rate 4 of 611, 0.65%) were D– (p = 0.004; chi-square test). Of the alloantibodies to Lewis blood group system antigens, the majority were anti-Leb alone (7 of 14 donors, 50

S. Malhotra, G. Negi, D. Kaur, S.K. Meinia, A.K. Tiwari, S. Mitra

Immunohematology, Volume 36 , ISSUE 3, 93–98

Report | 01-December-2019

Prevalence of clinically significant red blood cell alloantibodies in pregnant women at a large tertiary-care facility

antibodies were anti-E (n = 31), anti-M (n = 25), and anti-K (n = 16). A total of eight pregnancies with alloantibodies required intrauterine transfusions with the specificities of anti-D; anti-D,-C (n = 2); anti-D,-C,-E; anti-D,-C,-K; anti-D,-C,-Jkb; anti-D,-S; and anti-E,-c. At a large academic tertiary-care center, approximately 1 in 83 obstetric patients had one or more RBC alloantibodies capable of causing HDFN. Anti-E, -M, and -D were the most frequent specificities, respectively.

Heather M. Smith, Rosetta S. Shirey, Sandra K. Thoman, Jay B. Jackson

Immunohematology, Volume 29 , ISSUE 4, 127–130

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