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Article | 16-October-2019

Adsorption of cold agglutinins with rabbit red blood cells

Cold-reactive autoagglutinins may mask the presence of underlying clinically significant alloantibodies. Adsorption with rabbit red blood cells (RBCs) or stroma can remove cold autoagglutinins found in the patient’s plasma/serum that are directed towards antigens expressed on the surface of rabbit RBCs. By removing these cold autoagglutinins, it is then possible to determine whether any underlying alloantibody reactivity is present. Although this method may also unintentionally adsorb

Adam Cobaugh

Immunohematology, Volume 34 , ISSUE 2, 46–48

Article | 16-October-2019

Separation of multiple antibodies by adsorption with allogeneic red blood cells

Principle Antibody detection and identification are processes that are commonly performed in the transfusion service before the transfusion of allogeneic red blood cells (RBCs). Antibody identification usually follows the discovery of a positive antibody detection test, or other factors such as ABO serum/cell discrepancy or incompatible crossmatch.1 Antibody identification is a necessary practice in blood banking to determine blood products that are suitable for transfusion to an individual

E.M. Ekema

Immunohematology, Volume 33 , ISSUE 4, 155–158

Article | 14-October-2020

Evaluation of a new solid-phase immunoassay for alloantibody detection using bromelin-treated and untreated red blood cells

The enzyme test is used to detect certain antibodies or facilitate antibody identification. This study compares antibody reactivity with bromelin-treated red blood cells (RBCs) and untreated RBCs using a newly developed solid-phase immunoassay. The reactivity of irregular antibodies was tested by a magnetic-mixed passive hemagglutination assay (M-MPHA). In addition, antibody reactivity was tested with dried stroma of bromelin-treated RBCs and untreated RBCs (M-MPHA-Dry). Rh antibodies were

Toyohiro Tamai, Toshio Mazda

Immunohematology, Volume 17 , ISSUE 1, 17–21

Case report | 14-October-2020

Discrepancies in Rh(D) typing of sensitized red blood cells using monoclonal/polyclonal anti-D reagents: case report and review

Instructions included with monoclonal Rh(D) typing reagents do not require routine use of an Rh control as immunoglobulin-coated red blood cells (RBCs) rarely yield falsely positive results with low protein reagents. However, the American Association of Blood Banks (AABB) Technical Manual recommends a concurrent control be performed on patients’ RBCs that type as group AB, D+. Proficiency testing surveys presented sensitized AB, D– RBCs, which resulted in a positive direct

Beverly J. Padget, Judith L. Hannon

Immunohematology, Volume 17 , ISSUE 1, 10–13

Article | 15-February-2021

ZZAP treatment of red blood cells

Principle ZZAP is a mixture of a sulfhydryl reagent (dithiothreitol [DTT]) and a proteolytic enzyme (papain or ficin). It was first described by Branch and Petz in their 1982 article in the American Journal of Clinical Pathology.1 ZZAP is used to dissociate IgG and complement from red blood cells (RBCs), an action that neither reagent can achieve alone. According to Branch and Petz, it is believed that ZZAP “reduces interchain disulfide linkages, increasing exposure of the IgG polypeptides to

S.I. Marckwardt

Immunohematology, Volume 35 , ISSUE 1, 9–10

Review | 01-December-2019

Warm autoadsorption with enzyme-treated red blood cells

Patients demonstrating warm autoantibody specificity present serologic challenges for laboratory staff performing antibody identification in the blood bank. Autoantibody can be removed from plasma or serum by adsorption onto autologous red blood cells (RBCs) provided the patient has not been transfused in the previous 3 months. The adsorption process can be enhanced by enzyme pretreatment of autologous RBCs.

Farai Tsimba-Chitsva, Susanne Bishop, Kelly Kezeor

Immunohematology, Volume 28 , ISSUE 3, 88–90

Article | 16-October-2019

Detecting polyagglutinable red blood cells

Polyagglutination is a condition in which red blood cells (RBCs) are agglutinated by normal adult human sera but not by autologous or newborn sera. Polyagglutination is caused by changes in the RBC membrane that enable patient RBCs to agglutinate with normal human sera; this agglutination can interfere with blood bank testing. Depending on the cause, polyagglutination may or may not be the cause of RBC hemolysis. Lectins and human sera can be used to detect polyagglutinable RBCs. Identification

Cami Melland, Connie Hintz

Immunohematology, Volume 34 , ISSUE 3, 113–117

Article | 16-October-2019

Dithiothreitol treatment of red blood cells

Principle Dithiothreitol (DTT) is a reducing agent capable of irreversibly cleaving accessible disulfide bonds when the solution pH is >7. DTT treatment of red blood cells (RBCs) will modify the tertiary structure of protein-based erythrocyte membrane antigens if their confirmation depends on disulfide bonds.1 Antigens of the following blood group systems are destroyed or weakened by 0.2 M DTT treatment: KEL, IN, JMH, YT, LU, MER2, KN, DO, CROM, and LW.2,3 Antibodies directed at antigens in

C.B. Bub

Immunohematology, Volume 33 , ISSUE 4, 170–172

Review | 01-December-2019

EDTA glycine acid treatment of red blood cells

IgG dissociation is necessary when a sample is direct antiglobulin test (DAT) positive and antigen testing using blood grouping serum reactive by the antiglobulin test is performed. Exposure of IgG-coated red blood cells (RBCs) to a low pH of 3.0 with EDTA glycine acid successfully dissociates the IgG, rendering the RBCs DAT negative 82 to 85 percent of the time. The procedure takes one minute or less and leaves RBC antigens intact and able to be typed except for those antigens in the Kell

Joanne Kosanke

Immunohematology, Volume 28 , ISSUE 3, 95–96

Article | 18-October-2020

A quick and simple method for phenotyping IgG-sensitized red blood cells

Positive (IgG) direct antiglobulin test (DAT) reactivity ranging from weakly positive to 2+ can be eliminated using a simple “blocking” technique with anti-IgG. This method can be used for antigen typing DAT-positive red blood cells that require the antiglobulin technique.

Thom S. Sererat, Douglas W. Veidt, Ann M. Dutched

Immunohematology, Volume 16 , ISSUE 4, 154–156

Article | 28-April-2020

Reactivity of FDA-approved anti-D reagents with partial D red blood cells

W. John Judd, Marilyn Moulds, Gloria Schlanser

Immunohematology, Volume 21 , ISSUE 4, 146–148

Article | 22-January-2021

Freezing and recovering rare red blood cells using glycerol

Principle According to the AABB Standards for Immunohematology Reference Laboratories, an accredited immunohematology reference laboratory (IRL) must maintain an appropriate inventory of reagent red blood cells (RBCs) for testing. This inventory should include RBCs negative for high-prevalence antigens, such as Kpb, Jsb, and Vel, as well as rare phenotypes, such as PP1Pk, Rhnull, and Kiddnull, which are not readily available in commercial panel cells.1 When such rare RBC phenotypes are

B. Eades

Immunohematology, Volume 36 , ISSUE 3, 85–88

Report | 21-March-2020

Unexplained agglutination of stored red blood cells in Alsever's solution caused by the gram-negative bacterium Serratia liquefaciens

Irene Martincic, Cherie (Cameron) Mastronardi, Amy Chung, Sandra Ramirez-Arcos

Immunohematology, Volume 24 , ISSUE 2, 39–44

Report | 06-November-2019

Drug-induced immune hemolytic anemia: the last 30 years  of changes

Drug-induced immune hemolytic anemia (DIIHA) is a rare condition that occurs primarily as a result of drug-induced antibodies, either drug-dependent or drug-independent. Drugdependent antibodies can be detected by testing drug-treated red blood cells (RBCs) or untreated RBCs in the presence of a solution of drug. Drug-independent antibodies react with untreated RBCs (no drug added) and cannot be distinguished from warm autoantibodies.  Many changes have occurred during the last 30 years

Patricia A. Arndt

Immunohematology, Volume 30 , ISSUE 2, 44–54

Article | 22-November-2020

Glycine-EDTA treatment to prepare Ko red blood cells: preservation of high-frequency antigens

Reactivity of high-incidence antigens after glycine-EDTA treatment of red blood cells (RBCs) to prepare artificial Ko RBCs was investigated. The treatment had little or no effect on Yta, JMH, Yka, Kna, and McCa. Hy antigen-positive-treated RBCs reacted less well with anti-Hy when compared to nontreated cells. Glycine-EDTA treatment to prepare Ko RBCs offers an advantage over AET treatment because it preserves some high-frequency antigens that AET treatment does not.

Jana Julleis, Cindy Sapp, Ram Kakaiya

Immunohematology, Volume 10 , ISSUE 2, 64–65

Article | 17-November-2020

Elimination of a requirement for Vel-negative red blood cells and successful transfusion following chromium-51 survival study

A 42-year-old woman presented with anemia and complex serologic test results that included a requirement for Vel-negative red blood cells (RBCs). Rare Vel-negative units were located and transfused, but her anemia worsened. As further serologic evaluation was inconclusive, an in vivo recovery study with Vel-positive RBCs was performed. Normal 24-hour recovery of these cells resulted in removal of the Vel-negative antigen restriction and successful transfusion of the patient. Resolution of the

Richard J. Davey, Jo Lynn Procter

Immunohematology, Volume 11 , ISSUE 2, 39–42

Article | 16-November-2020

A method to detect McLeod phenotype red blood cells

It is important to identify the McLeod phenotype in order to differentiate the McLeod syndrome from other causes of acanthocytosis, e.g., chorea acanthocytosis. A proportion of males with the McLeod phenotype have X-linked chronic granulomatous disease. Because anti-Kx + -Km, which is needed for identification, is not readily available, detection of the McLeod phenotype relies on observed weakening of Kell antigens on the individual’s red blood cells (RBCs). Identification of McLeod

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

Immunohematology, Volume 12 , ISSUE 4, 160–163

Article | 09-November-2020

Practical method for determination of the U status of S–s– erythrocytes

Red blood cells (RBCs) lacking S and s blood group antigens are classified as S–s–U– or S–s–U+var but the classification may vary due to the characteristics of anti-U and to the technique used. Tests on RBCs known to lack glycophorin B (GPB) or to possess an altered form of GPB showed that polyethylene glycol-indirect antiglobulin testing or MicroTyping Systems (MTS)-gel techniques can be used as a simple and reliable way to detect RBCs with variant forms of GPB

Marion E. Reid, Jill R. Storry, Joan Maurer, Sandra T. Nance

Immunohematology, Volume 13 , ISSUE 4, 111–114

Article | 30-November-2020

Loss and reappearance of RhO(D) antigen on the red blood cells of an individual with acute myelogenous leukemia

Complete loss of Rho(D) antigen from red blood cells (RBCs) of individuals with hematologic disorders, though not frequent, has been reported. This case reports the loss of D antigen on the RBCs of a patient with acute myelogenous leukemia and its reappearance when he was in remission. Loss of D antigen expression coincided with worsening clinical and cytogenetic disease. At the time of D antigen loss, the patient also had cytogenetic abnormalities in the bone marrow cells. When he was in

Kala Mohandas, Vesna Najfeld, Harriet Gilbert, Penny Azar, Donna Skerrett

Immunohematology, Volume 10 , ISSUE 4, 134–135

Report | 01-December-2019

Transfusion of D+ red blood cells to D– individuals in trauma situations

To conserve D– red blood cells (RBCs), our facility developed a policy for transfusion of D+ units to D– patients, particularly in trauma situations. To our knowledge, this is the first study looking at D-mismatched RBC transfusion in trauma patients. We developed guidelines for the transfusion of D-mismatched RBCs. Patients were followed by antibody screening and direct antiglobulin testing. Twenty-six patients were identified, and 57.7 percent of the cases were the result of

Amanda Tchakarov, Rhonda Hobbs, Yu Bai

Immunohematology, Volume 30 , ISSUE 4, 149–152

Report | 01-December-2019

Low risk of hemolysis after transfusion of uncrossmatched red blood cells

Transfusing uncrossmatched red blood cells (RBCs) can be a lifesaving bridge until crossmatched RBCs are available. The risk of using uncrossmatched RBCs is that of hemolysis from unexpected clinically significant antibodies. This study sought to quantify the risk of hemolysis after the transfusion of uncrossmatched RBCs. The records of recipients of uncrossmatched RBCs over approximately 9 months were retrieved from the regional transfusion service. Basic immunohematologic data were recorded

Lisa Radkay, Darrell J. Triulzi, Mark H. Yazer

Immunohematology, Volume 28 , ISSUE 2, 39–44

Article | 26-October-2020

EDTA/glycine-acid versus chloroquine diphosphate treatment for stripping Bg antigens from red blood cells

EDTA/glycine-acid (EGA) has been reported to remove IgG-bound antibodies from red blood cells (RBCs) and to denature Kell system and Era antigens. EGA-treated RBCs were tested in parallel with chloroquine diphosphate (CDP)-treated RBCs to evaluate whether EGA would remove Bg antigens from RBCs as efficiently as CDP. Fifty-seven serum/plasma samples containing known Bg antibodies were tested with untreated Bg+ RBCs, EGA-treated Bg+ RBCs, and CDP-treated Bg+ RBCs by an indirect antiglobulin test

Kayla D. Champagne, Peggy Spruell, Jane Chen, Leslie Voll, Gloria Schlanser

Immunohematology, Volume 15 , ISSUE 2, 66–68

Report | 06-November-2019

How we investigate drug-induced immune hemolytic anemia

antibodies are investigated by testing drug-treated red blood cells (RBCs) or by testing RBCs in the presence of a solution of drug. Drug-independent antibodies are serologically indistinct from idiopathic warm autoantibodies and cannot be defined or excluded by serologic testing. Nonimmunologic protein adsorption, caused by some drugs, is independent of antibody production but may also cause immune hemolytic anemia. Serologic methods for testing for drug antibodies are presented, and observations from

Regina M. Leger, Patricia A. Arndt, George Garratty

Immunohematology, Volume 30 , ISSUE 2, 85–94

Article | 06-December-2020

A weak B antigen with serologic reactivity between B1 and B2 red blood cells found in a Chinese family

During a serologic study on red cell samples from individuals representing three generations of a Chinese family, an unusual pattern of reactivity was noted in a sample from a daughter of an A1B2 individual. The results of direct ABO grouping, titration, and adsorption studies demonstrated that the red blood cells (RBCs) from the proposita and two of the proposita's uncles (1) expressed more B antigen than group B2 RBCs but less than group B1 RBCs; (2) expressed the B1 antigen but at a

Gongliang Zhang, Yiging Wang, Jie Zheng, Alice Lee, Robert J. Eckrich, Delores M. Mallory, Tsung Dao Lee

Immunohematology, Volume 9 , ISSUE 1, 11–14

Report | 26-October-2019

First example of an FY*01 allele associated with weakened expression of Fya on red blood cells

Duffy antigens are important in immunohematology. The reference allele for the Duffy gene (FY) is FY*02, which encodes Fyb. An A>G single nucleotide polymorphism (SNP) at coding nucleotide (c.) 125 in exon 2 defines the FY*01 allele, which encodes the antithetical Fya. A C>T SNP at c.265 in the FY*02 allele is associated with weakening of Fyb expression on red blood cells (RBCs) (called FyX). Until recently, this latter change had not been described on a FY*01 background allele

Patricia A. Arndt, Trina Horn, Jessica A Keller, Rochelle Young, Suzanne M. Heri, Margaret A. Keller

Immunohematology, Volume 31 , ISSUE 3, 103–107

Article | 09-November-2020

Measurement of red blood cell-bound C3b and C3d using an enzyme-linked direct antiglobulin test

J.D. Bellamy, D.J. Booker, N.T. James, R. Stamps, R.J. Sokol

Immunohematology, Volume 13 , ISSUE 4, 123–131

Case report | 01-December-2019

Performance of an automated solid-phase  red cell adherence system compared with  that of a manual gel microcolumn assay for  the identification of antibodies eluted from  red blood cells

IgG antibodies coating red blood cells (RBCs) can be removed by elution procedures and their specificity determined by antibody identification studies. Although such testing is traditionally performed using the tube agglutination assay, prior studies have shown that the gel microcolumn (GMC) assay may also be used with comparable results. The purpose of this study was to compare an automated solid-phase red cell adherence (SPRCA) system with a GMC assay for the detection of antibodies eluted

Rachel H. Finck, Rebecca J. Davis, Shih-Mao Teng, Dennis Goldfinger, Alyssa F. Ziman, Qun Lu, Shan Yuan

Immunohematology, Volume 27 , ISSUE 1, 1–5

Letter to Editor | 09-November-2020

Letters to the Editors: Loss of Rare Red Blood Cells

Jill Storry

Immunohematology, Volume 13 , ISSUE 3, 103–103

Article | 09-November-2020

Absence of hemolysis after a kidney transplant in an E+ recipient from a donor with anti-E

A 12-year-old Caucasian male with cystinosis received a kidney from his mother, whose red blood cells typed as group O, D+, E–. Her serum contained an anti-E with an IgG1 titer of 16 (score 31). The recipient’s type was group O, D+, E+, with a negative antibody screen in the pretransplant period. The recipient and donor Rh phenotypes were most likely DCcEe and Dccee, respectively. Because the recipient’s mother had no transfusion history, she was probably immunized by the

Marcia C. Zago-Novaretti, Carlos Roberto Jorge, Eduardo Jens, Pedro Enrique Dorihiac-Llacer, Dalton de Alencar Fischer Chamone

Immunohematology, Volume 13 , ISSUE 4, 138–140

Article | 18-October-2020

PEG-coated red blood cells - simplifying blood transfusion in the new millennium?

Timothy C. Fisher

Immunohematology, Volume 16 , ISSUE 1, 37–48

Article | 16-October-2019

Cold autoadsorption

Ernest M. Ekema

Immunohematology, Volume 34 , ISSUE 4, 158–160

Article | 18-October-2020

Large-scale use of red blood cell units containing alloantibodies

Martha R. Combs, Donald H. Bennett, Marilyn J. Telen

Immunohematology, Volume 16 , ISSUE 3, 120–123

Article | 15-April-2020

In search of red blood cells for alloimmunized patients with sickle cell disease

Cynthia Flickinger

Immunohematology, Volume 22 , ISSUE 3, 136–142

Editorial | 24-March-2020

Group O red blood cells in massive transfusion - when to pull the switch?

David N. Moolten

Immunohematology, Volume 24 , ISSUE 3, 116–118

Article | 27-December-2020

Resolution of discrepant typings observed in paternity testing

Discrepant results in phenotyping the red blood cells (RBCs) of a child and his alieged parents were attributable to a contaminating antibody, anti-Bgb (HLA B-17), in typing reagents (anti-C and -CW). This case demonstrates the necessity for using reagents from at least two sources for paternity testing.

Mary Lou Guizzo, Nancy Lang

Immunohematology, Volume 5 , ISSUE 2, 57–59

Article | 17-November-2020

Quantifying the loss of ABO antigenicity in a patient with acute myeloid leukemia by flow cytometric analysis

The loss of B antigenicity from the red blood cells of a patient with acute myeloid leukemia is reported. The patient had normal B transferase levels, but had reduced levels of H transferase. Flow cytometry was used to quantify the loss of B antigenicity and monitor the expression of the B antigen throughout the progression of the disease.

Hazel J. Popp, Margaret Nelson, Cecily Forsyth, Mark Falson, Harry Kronenberg

Immunohematology, Volume 11 , ISSUE 1, 5–7

Article | 15-February-2021

Heat elution: a modification of the Landsteiner-Miller method

between the antibody and its antigen is reversible and is affected by the ionic strength, temperature, and pH of the testing environment. The process of removing an antibody attached to red blood cells (RBCs), either in vivo or in vitro, is termed elution, and the recovered, concentrated antibody in solution is called an eluate. Heat elution, the first RBC elution procedure,2 was described by Landsteiner and Miller3 in their studies on chimpanzees. The original method involved a 5-minute incubation at

C. Dean-El, N. Quraishy

Immunohematology, Volume 35 , ISSUE 2, 45–47

Case report | 27-December-2020

A case report: unusual Gerbich antibody in a patient with sickle cell anemia

A patient whose red blood cells (RBCs) typed as Ge:2,3 produced an alloantibody to a high-frequency antigen in the Gerbich system. This antibody was shown to be nonreactive with Ge: -2, -3 RBCs using adsorption-elution studies. A monocyte monolayer assay (MMA) suggested that transfusion of Ge:2,3 RBCs to this patient would have reduced in vivo survival.

Michael I. Gorman, Bobbye Woody

Immunohematology, Volume 5 , ISSUE 2, 55–57

Article | 17-February-2021

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

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

Immunohematology, Volume 36 , ISSUE 2, 54–57

Article | 26-October-2020

DNA from urine sediment or buccal cells can be used for blood group molecular genotyping

Accurate blood group antigen typing of red blood cells with a positive direct antiglobulin test or from a recently transfused patient has been a long-standing problem. To overcome this problem, we evaluated the feasibility of using somatic cells as a source of DNA for molecular genotyping. Two sources of cells that could be obtained by noninvasive procedures were chosen for analysis: urine samples, which were already available in the clinical laboratory, and buccal epithelial cells collected

Marion E. Reid, Maria J. Rios, Kevin L. Cash, Annie M. Strupp, Joan M. Uehlinger

Immunohematology, Volume 15 , ISSUE 2, 61–65

Article | 16-October-2019

Anti-Vel alloimmunization and severe hemolytic disease of the fetus and newborn

K.J. Moise, Y. Morales, M.F. Bertholf, S.N. Rossmann, Y. Bai

Immunohematology, Volume 33 , ISSUE 4, 152–154

Book Review | 22-November-2020

BOOK REVIEW: A Handbook of Clinical and Laboratory Practices in the Transfusion of Red Blood Cells

Mary H. McGinniss

Immunohematology, Volume 10 , ISSUE 2, 66–67

Case report | 06-December-2020

Case report: serologic confirmation of paroxysmal cold hemoglobinuria

A child with a history of recent viral infection entered the hospital with severe anemia, hemoglobinuria, and suspected autoimmune disease. Serologic findings included a positive direct antiglobulin test and incompatible crossmatches. Extensive studies, including a Donath-Landsteiner test, confirmed paroxysmal cold hemoglobinuria. The child was transfused several times with washed red blood cells compatible by prewarm technique. Although hemolysis continued after each transfusion, he stabilized

Carol A. Putnam

Immunohematology, Volume 8 , ISSUE 1, 19–21

Review | 03-November-2020

In vitro reactions with red blood cells that are not due to blood group antibodies: a review

George Garratty

Immunohematology, Volume 14 , ISSUE 1, 1–11

Article | 16-October-2019

Warm autoadsorption using ZZAP

The masking of clinically significant alloantibodies by warm autoantibodies presents challenges in pretransfusion testing. The adoption of transfusion practices such as the issuing of “least incompatible” red blood cells (RBCs) without a complete antibody workup is potentially unsafe for patients. Several autoadsorption methods can be used to remove autoantibody reactivity. ZZAP treatment of autologous RBCs is an efficient way to prepare the cells for autoadsorption. Autoadsorbed

Farai M. Tsimba-Chitsva, Amy Caballero, Becky Svatora

Immunohematology, Volume 34 , ISSUE 1, 1–3

Review | 26-October-2019

Recovery of autologous reticulocytes by microhematocrit  cell separation

Reticulocytes can be separated from more mature red blood cells based on differences in density. A method for obtaining autologous reticulocytes in ethylenediaminetetraacetic acid (EDTA) whole blood samples containing both autologous and transfused cells uses a microhematocrit centrifuge. The less dense reticulocytes harvested from the top 5 mm of microhematocrit tubes can be used to determine the patient’s phenotype or assess whether a transfusion reaction is taking place. This method

Christy W. Hall

Immunohematology, Volume 31 , ISSUE 4, 152–154

Article | 09-November-2020

Anti-Jk3 with no clinical evidence of HDN

A sample was submitted to a reference lab from a 27-year-old Asian female, gravida 4 para 1, for antibody identification. Anti-Jk3 with an IgM component was identified. Subsequently, the antibody was eluted from the infant’s cord and venous red blood cells. Normal bilirubin and hematocrit levels ruled out hemolytic disease of the newborn (HDN). Anti-Jk3 has been implicated in two cases of mild HDN. In this case, this noncomplement-binding antibody caused a positive direct Coombs test

Celeste J. Hunter, Michael D. Ziebol

Immunohematology, Volume 13 , ISSUE 4, 136–137

Article | 16-November-2020

Characterization of human anti-hrB-like monoclonal antibody

To develop a blood typing reagent with Rh specificity, peripheral blood lymphocytes were isolated from a multiparous woman with apparent alloanti-Ce and fused with FIS heteromyeloma cells. One hybridoma cell line, FOR-2E3, secreted human IgG, which agglutinated all human red blood cells except R2R2, RZRZ, Dc–, D––, Rhnull, and e+ hrB–. The supernatant is useful as a reagent to screen for hrB– blood donors and to differentiate haplotypes with C and e in cis from

Antoine P. Blancher, Marion E. Reid, Simone J. Alié-Daram, Jean Michel H. Dugoujon, Francis L. Roubinet

Immunohematology, Volume 12 , ISSUE 3, 119–122

Article | 06-December-2020

A Polynesian family showing co-dominant inheritance of normal glycophorin C and the Gerbich variant form of glycophorin C

Two individuals with the rare Ge:-2.-3,4 phenotype (Gerbich type of Gerbich negative) were identified in a family of Polynesian descent who reside in the Cook Islands. In initial serologic tests, all other family members typed as Ge-positive. and heterozygous individuals could not be identified. Further studies on blood samples from seven members of this Polynesian family by immunoblotting and hemagglutination tests on trypsin-treated red blood cells showed that normal glycophorin C and the

Marion E. Reid, Joyce Poole, Yew W. Liew, Linda Pinder

Immunohematology, Volume 8 , ISSUE 2, 29–32

Article | 17-February-2021

An update on the RAPH blood group system

of nephropathy with proteinuria.7 Because MER2 phenotyping of the patient’s red blood cells (RBCs) was not performed, there is insufficient evidence to assign an allele; it is likely, however, that this defect eliminates MER2 expression. Table 1 RAPH alleles with ethnicity and single nucleotide variant frequency information Allele name Ethnicity Antigen phenotype rs number Minor allele frequency[GnomAD][TOPMED] Nucleotide changes Amino acid changes Reference34 RAPH*01N.01

M.A. Keller

Immunohematology, Volume 36 , ISSUE 2, 58–59

Article | 16-October-2019

Utility of chloroquine diphosphate in the blood bank laboratory

Chloroquine diphosphate (CDP) is a helpful tool in the blood bank for two main applications. The most common application is to render direct antiglobulin test–positive red blood cells (RBCs) free from membrane-bound IgG; these treated RBCs can then be used for autologous adsorption and/or to determine the patient’s RBC phenotype. Another common use of CDP is to remove human leukocyte antigens (HLAs) from RBCs to help identify or exclude the presence of antibodies to HLAs expressed

Thandar Aye, Patricia A. Arndt

Immunohematology, Volume 34 , ISSUE 3, 98–102

Article | 16-October-2019

Rouleaux and saline replacement

Rouleaux is a phenomenon that commonly occurs in patients who have an increased number of circulating protein macromolecules. It is a benign, in vitro reaction that appears microscopically as red blood cells (RBCs) line up against each other; many liken the RBC aggregation to “stacked coins.” This unexpected reactivity may cause confusion in direct agglutination testing such as reverse blood typing and crossmatching. Saline replacement is the established method to resolve rouleaux

Kayla L. Waider

Immunohematology, Volume 34 , ISSUE 3, 91–92

Article | 15-February-2021

An update on the CD59 blood group system

Introduction CD59 is a 20-kDa cell membrane glycoprotein, present on a large number of cells, including red blood cells (RBCs), that binds the complement components C8 and C9 and, thereby, protects the cell from a complement attack.1 CD59 was assigned a blood group system after a CD59-deficient child presented with anti-CD59, reacting with all CD59-carrying RBCs.2 In contrast to patients with paroxysmal nocturnal hemoglobinuria, where an acquired mutation in a stem cell clone causes the

C. Weinstock, M. Anliker, I. von Zabern

Immunohematology, Volume 35 , ISSUE 1, 7–8

case-report | 25-June-2021

Anti-A1Leb: a mind boggler

The Lewis blood group system (Le) is unique because it is the only system in which the antigens are not synthesized by red blood cells (RBCs); rather, the antigens are passively adsorbed onto the RBC membrane.1 Le antigens are soluble carbohydrate moieties formed by tissue cells and secreted by body secretions like saliva, where they appear as glycoproteins; in plasma, however, they appear as glycolipids. The Le phenotype depends on ABH secretor status of an individual, although FUT2 and FUT3

A. Gupta, K. Chaudhary, S. Asati, B. Kakkar

Immunohematology, Volume 37 , ISSUE 2, 69–71

Review | 01-December-2019

The LAN blood group system: a review

Thierry Peyrard

Immunohematology, Volume 29 , ISSUE 4, 131–135

Review | 09-October-2019

How to recognize and resolve reagentdependent reactivity: a review

Reagent-dependent reactivity can be described as agglutination of red blood cells (RBCs) in serologic testing that is not related to the interaction of RBC antigens and antibodies that the test system is intended to detect. In other words, reagent-dependent reactivity results in false-positive agglutination reactions in serologic testing. These false-positive reactions can cause confusion in antigen typing and RBC antibody detection and identification procedures, and may result in delays in

Gavin C. Patch, Charles F. Hutchinson, Nancy A. Lang, Ghada Khalife

Immunohematology, Volume 32 , ISSUE 3, 96–99

Review | 16-October-2019

Clinical significance of antibodies to antigens in the International Society of Blood Transfusion collections, 700 series of low-incidence antigens, and 901 series of high-incidence antigens

This article reviews information regarding the clinical significance of antibodies to antigens in the blood group collections, the 700 series of low-incidence antigens, and the 901 series of high-incidence antigens. Antibodies to many of the antigens in these groups are rarely encountered, meaning that available information is limited. For a few, the clinical significance— the potential to cause reduced survival of transfused antigen-positive red blood cells, a hemolytic transfusion

Christine Lomas-Francis

Immunohematology, Volume 34 , ISSUE 2, 39–45

Review | 01-December-2019

Allogeneic red blood cell adsorption for removal of warm autoantibody

Adsorption studies are usually required to confirm or rule out the presence of underlying alloantibodies in samples containing warm autoantibody. Allogeneic adsorptions are necessary if the patient has been recently transfused. Most commonly, allogeneic adsorptions are performed using a trio of phenotyped reagent red blood cells to rule out clinically significant alloantibodies to common antigens. The adsorbing cells may be used untreated or treated with enzymes or with ZZAP before adsorption

Christina Barron

Immunohematology, Volume 30 , ISSUE 4, 153–155

Report | 01-December-2019

Implications of the Kidd blood group system in renal transplantation

The association of the Kidd blood group system with hemolytic transfusion reactions and hemolytic disease of the newborn is well known. The Kidd antigens, which are localized to the HUT/UT-B urea transport protein, are found on red blood cells and the endothelial cells of the blood vessels of the medulla of the kidney. Recently it has been suggested that these antigens might play a role as minor histocompatibility antigens in renal transplantation. In the current case, the appearance of an anti

Angela Rourk, Jerry E. Squires

Immunohematology, Volume 28 , ISSUE 3, 91–94

Article | 15-February-2021

Albumin-indirect antiglobulin test

Principle Albumin is added to serologic tests to overcome forces keeping red blood cells (RBCs) apart and, in doing so, makes hemagglutination reactions more likely to occur. Use of albumin in antibody detection tests began as early as the 1940s before the advent of the antihuman globulin (AHG) phase of testing, when direct agglutination tests were the only available method for visualizing the antigen-antibody reaction. Initially, the reagent was used in albumin layering1,2 or albumin

J.R. Hamilton

Immunohematology, Volume 35 , ISSUE 2, 63–64

Case report | 09-November-2020

Antibodies to low-incidence antigens and elimination of the antihuman globulin phase of the crossmatch - case report: anti-Wra

An antibody to a low-incidence antigen was identified in the serum of a nontransfused male patient. The antibody was subsequently identified as anti-Wra and was only detectable at the antihuman globulin (AHG) phase of the crossmatch. Instances of severe hemolytic transfusion reactions have been reported following the transfusion of red blood cells containing low-incidence antigens in patients with antibodies directed toward these antigens (e.g., antiWra, -Cob, -Jsa, etc.). Elimination of the

Scott C. Wise, Patricia J. Larison, Lloyd O. Cook

Immunohematology, Volume 13 , ISSUE 1, 20–22

Report | 01-December-2019

The prevention and management of alloimmunization in sickle cell disease: the benefit of extended phenotypic matching of red blood cells

Elliott Vichinsky

Immunohematology, Volume 28 , ISSUE 1, 20–23

Review | 01-December-2019

Immunosuppressive protocols for transplantation and certain hematologic malignancies can prevent the primary immune response to the D blood group antigen

A review of the published literature on Rh alloimmunization reveals that its incidence varies with the volume of infused D+ red blood cells (RBCs), the probable Rh genotype of the RBCs, and the immune competency of the D– recipient. Among the reports of Rh alloimmunization in different clinical circumstances, we identified five studies in which a combined total of 62 D– recipients of hematopoietic stem cell or solid-organ transplants were transfused with D+ RBCs and none (0%) formed

Adair Seager, S. Gerald Sandler

Immunohematology, Volume 29 , ISSUE 3, 110–114

Case report | 11-March-2020

Persistent complement-dependent anti-AnWj in a lymphoproliferative disorder: a case study and review

AnWj is a high-incidence antigen present on the red blood cells (RBCs) of greater than 99 percent of the general population. A 58-year-old man underwent autologous hematopoietic stem cell transplantation (HSCT) for stage IVa mantle cell lymphoma. This procedure was complicated by failure to engraft, necessitating ongoing support with blood components. After a 2-month period of uneventful transfusion support, the patient experienced increasingly severe reactions with fever and evidence of

George Grigoriadis, Jennifer Condon, Kate Green, Mary Ann Anderson, Marija Borosak, Erica Wood

Immunohematology, Volume 27 , ISSUE 3, 83–88

Article | 14-October-2020

Nondetection of the S antigen due to the presence of sodium hypochlorite

Low concentrations of sodium hypochlorite (chlorine bleach) are known to destroy S antigen on intact fresh red blood cells (RBCs). Sodium hypochlorite is commonly used as a disinfectant. We report nondetection of the S antigen in tube and microplate saline indirect antiglobulin testing (SIAT) with a lot of commercial saline utilized in our donor screening and reference laboratories. Known S+s+ RBCs were found to be nonreactive with anti-S by SIAT in our reference laboratory. Our investigation

Anne Long, Lyne Tremblay, Lucie Richard, Réal Lemieux, Mindy Goldman

Immunohematology, Volume 18 , ISSUE 4, 120–122

Article | 03-November-2020

GIL: a red cell antigen of very high frequency

A new high-frequency red cell antigen has been identified and named GIL. GIL differs from all high-frequency antigens included in the International Society of Blood Transfusion classification. There is very little family information and GIL has not been shown to be an inherited character. Five women with anti-GIL have been found. All had been pregnant at least twice. Red blood cells of two of the babies gave positive direct antiglobulin tests, but there were no clinical signs of hemolytic

Geoff Daniels, E. Nicole DeLong, Virginia Hare, Susan T. Johnson, Pierre-Yves LePennec, Delores Mallory, M. Jane Marshall, Cindy Oliver, Peggy Spruell

Immunohematology, Volume 14 , ISSUE 2, 49–52

Review | 09-October-2019

The H blood group system

The H blood group system, ISBT symbol H (018), consists of a single antigen (H) defined by a terminal fucose residue found on red blood cells and in secretions formed by the action of α-1,2-fucosyltransferases 1 (α2FucT1) and 2 (α2FucT2), respectively. Mutant alleles of the corresponding FUT1 and FUT2 genes result in either a H– phenotype (Bombay phenotype, Oh) or a weak H phenotype (para-Bombay, H+w). In addition, the FUT2 gene is the molecular basis of the secretor (Se

Erwin Andreas Scharberg, Coral Olsen, Peter Bugert

Immunohematology, Volume 32 , ISSUE 3, 112–118

Article | 16-October-2019

Low-ionic-strength saline solution–antiglobulin test (LISS-AGT)

The use of low-ionic-strength saline (LISS) solution as an enhancement for antibody screening and crossmatching was first described by Löw and Messeter in 1974. This method allowed for a reduced incubation time while maintaining adequate specificity and sensitivity of the antiglobulin test (AGT). Since then, the LISS-AGT tube method has been widely used in antibody detection and identification, as well as compatibility testing. As initially described, the method used red blood cells

LeeAnn Walker

Immunohematology, Volume 34 , ISSUE 2, 57–60

Case report | 01-December-2019

Major non-ABO incompatibility caused by anti-Jka in a patient before allogeneic hematopoietic stem cell transplantation

A 49-year-old white man with blood group AB, D+ was found to have alloanti-Jka and -K when he developed a delayed hemolytic transfusion reaction before allogeneic hematopoietic stem cell transplant (HSCT). Given that his stem cell donor was blood group O, D+, Jk(a+), K–, rituximab was added to his conditioning regimen of fludarabine and melphalan to prevent hemolysis of engrafting Jk(a+) donor red blood cells. The patient proceeded to receive a peripheral blood stem cell transplant from a

Miriam Y. Kim, Preeti Chaudhary, Ira A. Shulman, Vinod Pullarkat

Immunohematology, Volume 29 , ISSUE 1, 11–14

Article | 14-October-2020

Low-incidence MNS antigens associated with single amino acid changes and their susceptibility to enzyme treatment

identified changes in amino acids that are associated with several low-incidence antigens in the MNS blood group system. This review relates the molecular studies with the susceptibility or resistance of these antigens to treatment of intact red blood cells by proteolytic enzymes.

Marion E. Reid, Jill Storry

Immunohematology, Volume 17 , ISSUE 3, 76–81

Article | 26-October-2020

Precipitation of serum proteins by polyethylene glycol (PEG) in  pretransfusion testing

Polyethylene glycol (PEG) is used as a potentiator of blood group antigen-antibody interactions. Although PEG is known to precipitate immunoglobulins, we could find no reports of this reagent entrapping red blood cells (RBCs) in irreversible clumps. The patient we describe here had hyperglobulinemia with a reversed albumin: globulin ratio and a diffuse immunoglobulin peak on serum protein electrophoresis. During preparation of serologic tests, a precipitate formed that entrapped the RBCs when

Jack Hoffer, William P. Koslosky, Elizabeth S. Gloster, Therese M. Dimaio, Marion E. Reid

Immunohematology, Volume 15 , ISSUE 3, 105–107

Article | 15-February-2021

An update on the H blood group system

E.A. Scharberg, C. Olsen, P. Bugert

Immunohematology, Volume 35 , ISSUE 2, 67–68

Review | 16-October-2019

Clinical significance of antibodies to antigens in the Raph, John Milton Hagen, I, Globoside, Gill, Rh-associated glycoprotein, FORS, JR, LAN, Vel, CD59, and Augustine blood group systems

transfused antigenpositive red blood cells or a transfusion reaction (e.g., anti-P, anti-Jra, and anti-Lan), and/or hemolytic disease of the fetus and newborn (e.g., anti-RHAG4 and anti-Vel)—has been documented. For other antibodies, their prevalence is so rare that information on the clinical significance of their antibodies is not available (e.g., anti-FORS1).

Mostafa Moghaddam, Amir Ali Naghi

Immunohematology, Volume 34 , ISSUE 3, 85–90

Article | 16-October-2019

Use of the prewarm method for detecting clinically significant alloantibodies in the presence of cold autoantibodies

The prewarm (PW) method is useful for detecting and identifying clinically significant antibodies that bind to red blood cells and complement at 37°C and for avoiding antibodies that bind at temperatures less than 37°C. Antibodies that bind at temperatures less than 37°C are often cold autoantibodies that may be present in the serum of healthy individuals and are usually not clinically significant. The PW method is useful when these cold autoantibodies have a wide thermal range and

Stephanie Dupuis

Immunohematology, Volume 34 , ISSUE 4, 148–150

Article | 14-October-2020

One thousand seventy antibodies detected only by a 2-stage papain test: wanted and unwanted positive reactions

Despite the wide use of the antibody detection test for unexpected antibodies, controversy still remains regarding the use of enzymetreated red blood cells. Over a 6-year period, 72,573 samples from 49,863 patients submitted for pretransfusion compatibility testing were examined for unexpected antibodies. The antibody detection tests included a low-ionic-strength solution (LISS) indirect antiglobulin test and a two-stage papain (2SP) test. One thousand and seventy of the 2267 (47%) antibodies

Carmen Martin-Vega, Dolores Castella, Joan Cid, Marta Panadés

Immunohematology, Volume 17 , ISSUE 4, 122–124

Article | 10-November-2020

Glycophorin A-deficient red cells may have a weak expression of C4-bound Ch and Rg antigens

The blood group antigens Ch and Rg are polymorphisms of C4d. Antigen-positive red blood cells (RBCs) treated with proteases type as Ch-, Rg-. Although RBCs treated with sialidase may type Ch+ Rg+, they cannot be coated with C4 by the 10 percent sucrose method. Since studies of complement binding have shown that glycophorin A (GPA) is an important component for the uptake of C4 by RBCs, we tested all available GPA-deficient RBCs for their Ch and Rg status. Using eluates of human anti-Ch and anti

Patricia Tippett, Jill Storry, Phyllis Walker, Yasuto Okubo, Marion Reid

Immunohematology, Volume 12 , ISSUE 1, 4–7

Case report | 30-November-2020

Case report: IgG1 Rh antibodies causing moderate hemolytic disease of the newborn

was group A, D positive, E negative, with a 3+ direct antiglobulin test. The eluate revealed anti-D and -hrB. Treatment of the hemolytic disease of the newborn included phototherapy, intravenous fluids, and transfusion of 60 mL of mother's deglycerolized red blood cells.

C. Faye Kugele, Cindy K. Oliver, Maria A. Carney, Jayne Hollander

Immunohematology, Volume 10 , ISSUE 4, 124–126

Article | 01-April-2020

Reduced red blood cell destruction by antibody fragments

Amina Mqadmi, Steven Abramowitz, Xiaoying Zheng, Karina Yazdanbakhsh

Immunohematology, Volume 22 , ISSUE 1, 11–14

Article | 16-October-2019

Recovery of autologous sickle cells by hypotonic wash

It is important to isolate autologous red blood cells (RBCs) from transfused RBCs in samples from recently transfused patients to ensure that accurate serologic results are obtained. Typically, this isolation can be performed using methods that separate patient reticulocytes from transfused, older donor RBCs. Patients with sickle cell disease (SCD), however, characteristically have RBCs with altered membrane and morphological features, causing their RBCs to take on a sickle-shape appearance

Emily Wilson, Kelly Kezeor, Monica Crosby

Immunohematology, Volume 34 , ISSUE 1, 16–18

Review | 01-December-2019

An update on the GLOB blood group system and collection

The P blood group antigen of the GLOB system is a glycolipid structure, also known as globoside, on the red blood cells (RBCs) of almost all individuals worldwide. The P antigen is intimately related to the Pk and NOR antigens discussed in the review about the P1PK blood group system. Naturally occurring anti-P is present in the serum of individuals with the rare globosidedeficient phenotypes p, P1k, and P2k and has been implicated in hemolytic transfusion reactions as well as unfavorable

Åsa Hellberg, Julia S. Westman, Martin L. Olsson

Immunohematology, Volume 29 , ISSUE 1, 19–24

Article | 16-November-2020

A second example of anti-Esa, an antibody to a high-incidence Cromer antigen

A blood sample contained an antibody to a high-incidence antigen that reacted with all red blood cells (RBCs) tested by the indirect antiglobulin test (IAT). The antibody reacted with papain-, ficin-, and trypsin-treated RBCs, but not with α-chymotrypsin-treated RBCs. This pattern of reactivity suggested the possibility that the antibody was recognizing an antigen in the Cromer blood group system. Tests against RBCs deficient in decay-accelerating factor (which carries the Cromer antigens

Marion E. Reid, Roselyn Marfoe, Anita Mueller, Patricia A. Arndt, Laima Sausais, Peggy Spruell

Immunohematology, Volume 12 , ISSUE 3, 112–114

Article | 29-December-2020

Immunoglobulin A (IgA) levels in blood products and plasma derivatives

lgA was measured by radial immunodiffusion and enzyme-linked immunosorbent assay techniques. Blood products which consistently contained IgA less than 0.05 mg/dL (the present definition for IgA deficiency used by the American Red Cross Rare Donor Registry) were from IgA-deficient donors, deglycerolized red blood cells (RBCs) prepared with an extra wash cycle, and RBCs washed using a total volume of approximately 1300 mL of 0.9 percent sodium chloride.

Susan M. Fox, Linda M. Stavely-Haiber

Immunohematology, Volume 4 , ISSUE 1, 5–9

Article | 16-February-2021

Clinical approach after identification of a rare anti-Ena in a prenatal sample

P.J. Howard, L. Guerra, D.K. Kuttner, M.R. George

Immunohematology, Volume 35 , ISSUE 4, 159–161

Article | 09-October-2019

Applications of selected cells in immunohematology in a developing country: case studies

When an antibody is detected, its specificity should be determined and its likely clinical significance should be assessed. When one antibody has been identified, it becomes necessary to confirm the presence of additional significant antibodies to ensure that compatible blood is provided to the patient. To perform this confirmation, specific reagent red blood cells (RBCs) are selected; these are called selected cells. Though the most common use of selected cells is for antibody confirmation

Ravi C. Dara Dara, Aseem Kumar Tiwari, Dinesh Arora, Subhasis Mitra, Geet Aggarwal, Devi Prasad Acharya, Gunjan Bhardwaj

Immunohematology, Volume 33 , ISSUE 1, 27–35

Article | 30-November-2020

First example of Rh:-32,-46 red cell phenotype

The red cells of a white male blood donor typed as Rh:-1, -2, -3, w4, w5, 6, -17, w19, -31, -32, -34, and -46. Although the donor has no history of transfusion, his serum contains an alloantibody that is weakly reactive with most red blood cells (RBCs) tested. Only Rhnull and D-- RBCs are nonreactive. Reactivity is enhanced with ficin- or papain-treated RBCs and is unaffected by AET or DTT treatment of the RBCs. Previously described Rh:-46 RBCs have been of deletion types D--, D•&bull

Jill Storry, Michael Gorman, Nancy I. Maddox, Ella Toy, Peter D. Issitt, Delores M. Mallory

Immunohematology, Volume 10 , ISSUE 4, 130–133

Article | 30-November-2020

Autoimmune hemolysis following transfusion: a mimicking autoanti-D in a D- patient with alloanti-D

An 80-year-old group O, D- (rr) female with anti-C, -D, -E, and -Fya received four units of crossmatch-compatible red blood cells (RBCs). The direct antiglobulin test (DAT) was negative. Two weeks later, jaundice, dark urine, a 16% drop in hematocrit (Hct), a 20% reticulocyte count, and absent haptoglobin occurred. During the next month, her DAT was positive with anti-IgG and -C3d. Acid eluates, which repeatedly showed anti-D specificity, were nonreactive with enzyme-treated D- RBCs. Adsorption

Walter H. Dzik, Joyce Blank, Paula Lutz, Thomas G. Hirose, Christine Lomas-Francis, Marilyn Moulds

Immunohematology, Volume 10 , ISSUE 4, 117–119

Article | 14-December-2020

The sensitivity of antibody detection testing using pooled versus unpooled reagent red cells

Because the sensitivity of antibody detection testing may be reduced when pooled reagent red blood cells (RBCs) are used, the American Association of Blood Banks (AABB) prohibits the use of pooled reagent RBCs when performing pretransfusion antibody detection testing. This restriction imposed upon the use of pooled reagent RBCs is based, at least in part, on the belief that pooled reagent RBCs are less likely to detect clinically significant antibodies than are sets of unpooled reagent RBCs

Ira A. Shulman, Roland Nakayama, Cintia Calderon

Immunohematology, Volume 7 , ISSUE 1, 16–19

Case report | 29-December-2020

A case report: cold hemagglutinin disease in a pancreatic and renal transplant patient

A 33-year-old white male, 30 days postpancreatic transplant, with a history of juvenile onset diabetes mellitus and previous renal transplant, appeared to have cold hemagglutinin disease (CHD). He was being treated for acute organ rejection and had received two units of red blood cells (RBCs) on postoperative day 11, at which time no serum antibodies were detectable. On postoperative day 30, serum studies showed an autoanti-I with a titer of 512 in 30 percent albumin at 4°C and a maximum

Catherine Y. Beiting, Kathleen S. Larimore

Immunohematology, Volume 4 , ISSUE 4, 85–87

Article | 14-October-2020

Screening for RBC antibodies - what should we expect from antibody detection RBCs

In the United States, the Food and Drug Administration mandates that red blood cells (RBCs) for antibody detection possess the following antigens: C, D, E, c, e, M, N, S, s, P1, Lea , Leb , K, k, Fya, Fyb, Jka, and Jkb. Although not required, it is generally agreed that homozygosity for C, D, E, c, e, Fya, and Jka is also preferable.There is no requirement for low-frequency antigens to be present.However, manufacturers of antibody detection RBCs receive requests for these RBCs to possess Cw

George Garratty

Immunohematology, Volume 18 , ISSUE 3, 71–77

Case report | 14-December-2020

Case report and review: alloimmunization, delayed hemolytic transfusion reaction, and clinically significant anti-Yta in a patient with ß-thalassemia/sickle cell anemia

A 26-year-old female with ß-thalassemia/sickle cell anemia was admitted to the hospital with symptoms of a painful crisis. During the next 4 days her hematocrit decreased to 13 percent, and there was reticulocytopenia. She was transfused with four units of red blood cells that were microscopically incompatible, and the hematocrit increased to 29 percent. Eight days later the patient was readmitted with back pain, hemoglobinuria, and a hematocrit of 27 percent. Anti-E, -c, -Jka, and -Yta

Christopher D. Hillyer, Jacquelynn M. Hall, Karen O. Tiegerman, Eugene M. Berkman

Immunohematology, Volume 7 , ISSUE 4, 102–106

Review | 14-October-2020

The Cromer blood group system: a review

DAF protein. The red blood cells (RBCs) of people with the Cromer null phenotype, Inab, lack DAF. Antibodies to Cromer antigens are rarely encountered although there is evidence that the antibodies may cause accelerated destruction of transfused RBCs. There is no risk of hemolytic disease of the newborn associated with Cromer system antibodies because the placenta is a rich source of fetally derived DAF, which is thought to adsorb the antibodies.

Jill R. Storry, Marion E. Reid

Immunohematology, Volume 18 , ISSUE 4, 95–103

Article | 14-October-2020

Serologic aspects of treating immune thrombocytopenic purpura using intravenous Rh immune globulin

In patients with immune thrombocytopenic purpura (ITP), IgG autoantibody-coated platelets are phagocytized by mononuclear macrophages, primarily in the spleen. Intravenous Rh immune globulin (IV RhIG) has been used since 1983 to treat D+, nonsplenectomized patients with ITP. The beneficial therapeutic effect of IV RhIG is attributed to competitive inhibition of phagocytosis of IgG-coated platelets by IgG anti-D-coated D+ red blood cells (reticuloendothelial or Fc receptor blockade). Following

Can M. Savasman, S. Gerald Sandler

Immunohematology, Volume 17 , ISSUE 4, 106–110

Article | 03-November-2020

Warm autoimmune hemolytic anemia associated with an IgM autoanti-Ge

A 28-year-old male with a prior history of Hodgkin’s disease and a recent upper respiratory tract infection presented with autoimmune hemolytic anemia (AIHA). The patient’s red blood cells (RBCs) were spontaneously agglutinated after room temperature and 37°C washes. Dithiothreitol-treated RBCs reacted strongly with anti-C3 and were nonreactive with anti-IgG, -IgM, and -IgA; they reacted with anti-IgM (κ light chains only) by flow cytometry. The patient’s serum was

Thom S. Sererat, Douglas W. Veidt, Patricia A. Arndt, George Garratty

Immunohematology, Volume 14 , ISSUE 1, 26–29

Report | 26-October-2019

Proposed criterion for distinguishing ABO mosaics from ABO chimeras using flow cytometric analysis

“A” or “B” antigen-negative and -positive red blood cells (RBCs) were set such that group O RBCs were classified as 99 percent negative and group A or B RBCs as 99 percent positive, the percentages of RBCs in the middle region of six chimeras and 23 mosaics (12 A mosaics and 11 B mosaics) were 0.1–0.6 percent and 7.0–19.0 percent, respectively. This result suggested that ABO mosaics and chimeras can be unambiguously differentiated when the cutoff point of the

Akira Oda, Nobuki Matsuyama, Mizuko Hirashima, Hiroyuki Ishii, Keiko Kimura, Harumichi Matsukura, Fumiya Hirayama, Keisei Kawa, Yasuo Fukumori

Immunohematology, Volume 31 , ISSUE 1, 24–28

Article | 06-December-2020

Reactive lysis - a phenomenon of delayed hemolytic transfusion reactions

A 62-year-old female with Gaucher's disease demonstrated alloanti-c on pretransfusion testing. She was transfused with five units of c-negative red blood cells (RBCs) preoperatively and intraoperatively. The hemoglobin (Hb) level was slightly lower initially, but was markedly lower on day 10 posttransfusion. Serologic results indicated a delayed hemolytic transfusion reaction (DHTR) due to alloanti-s, -Fya, and -Jkb, present both on the RBCs and in the serum. As late as day 35

Deborah L. Greene, Sanobar Khan

Immunohematology, Volume 9 , ISSUE 3, 74–77

Review | 09-October-2019

A Caucasian JK*A/JK*B woman with Jk(a+b–) red blood cells, anti-Jkb, and a novel JK*B allele c.1038delG

Glenn Ramsey, Ricardo D. Sumugod, Paul F. Lindholm, Jules G. Zinni, Jessica A. Keller, Trina Horn, Margaret A. Keller

Immunohematology, Volume 32 , ISSUE 3, 91–95

Review | 01-December-2019

Cold acid elution (ELU Kit II)

Elution is a procedure for recovery of antibody attached to intact, immunoglobulin-coated red blood cells (RBCs) by disrupting the antigen–antibody bonds. The recovered antibody is collected in an inert diluent and is referred to as an eluate. Testing of an eluate may be desired to identify antibody(ies) coating the RBCs of patients with a positive direct antiglobulin test. Many types of elution procedures have been developed and described; however, an acid elution is suitable for

Monica Hinrichs, Monica A. Keith

Immunohematology, Volume 30 , ISSUE 3, 113–116

Article | 30-November-2020

An example of anti-LWa in a 10-month-old infant

patient’s red blood cells (RBCs) typed as B, D-, LW(a-), K-, Fy(a-). Due to the age and clinical status of the child, 51Cr survival studies were not performed. One pediatric unit of D-, K-, Fy(a-) blood was transfused uneventfully; the expected increment of hemoglobin was achieved. Repeat testing 3 months later showed a weakly positive DAT, the patient’s RBCs typed as LW(a+), and anti-LWa was detected only by a two-stage papain technique. These results suggest that the patient had a

Alan Devenish

Immunohematology, Volume 10 , ISSUE 4, 127–129

Article | 22-November-2020

New human monoclonal antibody reagents for detecting C, c, E, e, K1, Jka, and Jkb red cell antigens

human and animal donors from whom variably reactive reagents are currently obtained. This ease of use and more rapid results should improve patient care by facilitating availability of phenotype-appropriate red blood cells for special needs.

Marti Kemper, Kathleen Sazama

Immunohematology, Volume 10 , ISSUE 1, 8–11

Review | 26-October-2019

Kell and Kx blood group systems

The Kell and Kx blood group systems are expressed as covalently linked molecules on red blood cells (RBCs). The Kell blood group system is very polymorphic, with 35 antigens assigned to the system. The expression of Kell glycoprotein on RBCs is not critical to the erythrocyte function. However, the expression of Kx is critical to normal morphology, and null mutations are associated with the McLeod neuroacanthocytosis syndrome. The immunogenicity of the K antigen is second only to the D antigen

Gregory A. Denomme

Immunohematology, Volume 31 , ISSUE 1, 14–19

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