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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 | 16-October-2019

Clinical and laboratory profile of anti-M

. Clinical Outcome of Anti-M in Patients and Donors Among the patients with anti-M, five patients required RBC transfusion. As in most of the cases, the IgG component was present along with IgM; hence, the anti-M was considered to be clinically significant, and these five patients received M– RBC units. The patient with ALL who had autoanti-M had clinical as well as laboratory features of hemolysis. The unconjugated bilirubin was increased at 1.5 mg/dL (normal 0–1.1 mg/dL), total bilirubin was 1.8 mg/dL

D. Basu, S. Basu, M. Reddy, K. Gupta, M. Chandy

Immunohematology, Volume 33 , ISSUE 4, 165–169

Article | 20-December-2020

An example of anti-JMH with characteristics of a clinically significant antibody

The authors studied an example of red cell anti-JMH (John Milton Hagen) that exhibited several characteristics of a possible clinically significant antibody able to cause red cell destruction in vivo. Strong serological reactivity, a positive monocyte monolayer assay, and immunoglobulin subclass determination as IgG3 all indicate possible ability to destroy red cells. A 51Cr-labeled red cell survival study was not done as the patient did not require red cell transfusions but may be recommended

John R. Geisland, Mary F. Corgan, Brenda L. Hillard

Immunohematology, Volume 6 , ISSUE 1, 9–11

Article | 03-November-2020

Improved detection of weak, clinically significant antibodies by supplementation of polyethylene glycol with a low-ionic solution

268 by both saline-IAGTs and RAM-IAGTs. The four antibodies that were not detected were identified as anti-D, anti-E, anti-Bga, and an autoantibody known previously to be only reactive with papain-pretreated red cells. No nonspecific reactions were detected by PEG-IAGTs and no hemolysis was evident in any of the IAGTs. PEG-IAGTs were more sensitive than saline- and RAM-IAGTs. PEG-IAGTs detected all weak, clinically significant antibodies as well as four antibodies that were otherwise undetected by

Kim Swee Low, Yew-Wah Liew, Peter M. Bradley

Immunohematology, Volume 14 , ISSUE 2, 68–71

Report | 01-December-2019

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

(3.0%) had one or more unexpected RBC antibodies. Of these 264 women, 107 (40.5%), or 1.2 percent overall, had an alloantibody known to cause HDFN, with a total of 15 different alloantibodies identified. The most common alloantibody found was anti-E (n = 33), followed by anti-M (n = 26) and anti-D (n = 20). In pregnancies of D– women, the most common clinically significant antibodies found were anti-D (n = 20), anti-C (n = 11), and anti-E (n = 2). In pregnancies of D+ women, the most common

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

Immunohematology, Volume 29 , ISSUE 4, 127–130

Article | 14-December-2020

Indicators of clinically significant red cell antibodies produced by sensitized lymphocytes in liver transplant patients

BeverIy E.W. Calhoun, M. Pothiawala, G. Musa, B. Baron

Immunohematology, Volume 7 , ISSUE 2, 37–39

Report | 12-March-2020

Determination of optimal method for antibody identification in a reference laboratory

Methods commonly used for antibody identification are hemagglutination (tube), column agglutination (gel), and solid-phase red cell adherence. Our AABB immunohematology reference laboratory (IRL) conducted a study to determine which antibody identification testing method was optimal for detecting all clinically significant antibodies. Patient specimens were sent to our IRL from August 2008 to September 2009. Routine testing was performed by tube method and then by manual gel and manual solid

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

Immunohematology, Volume 27 , ISSUE 4, 146–150

Letter to Editor | 16-October-2019

Letter to the Editor: Clinically significant naturally occurring anti-N and anti-S in a blood donor: a rare finding

Sheetal Malhotra, Gita Negi, Aseem Kumar Tiwari

Immunohematology, Volume 34 , ISSUE 2, 66–68

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 | 14-October-2020

Clinically significant autoimmune hemolytic anemia with a negative direct antiglobulin test by routine tube test and positive by column agglutination method

Marco Lai, Carlo Rumi, Giuseppe D’Onofrio, Maria Teresa Voso, Giuseppe Leone

Immunohematology, Volume 18 , ISSUE 4, 109–113

Article | 17-November-2020

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

This study compared the performance of polyethylene glycol (PEG) and low-ionic saline solutions (LISS) as enhancement media for routine use in a large transfusion service. A PEG additive solution (PEG plus LISS) was compared to a LISS additive (LISS plus polymers) and to an albumin-indirect antiglobulin test (A-IAT). Fifty serum samples containing clinically significant alloantibodies and fifty samples without alloantibodies were tested. Following an acute hemolytic transfusion reaction (HTR

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

Immunohematology, Volume 11 , ISSUE 1, 11–13

Review | 01-December-2019

Thermal amplitude test

The thermal amplitude test is performed to determine the reactivity of a cold autoantibody at varying temperatures: 4°C, 22°C, 30°C, and 37°C. Cold autoantibodies that are reactive at temperatures greater than 30°C have the potential to be clinically significant regardless of the antibody titer. Cold autoantibodies that are reactive at temperatures less than 30°C are not considered to be clinically significant.

Courtney Hopkins, Tiffany K. Walters

Immunohematology, Volume 29 , ISSUE 2, 49–50

Article | 16-October-2019

Cold autoadsorption

Cold-reactive autoantibodies can mask the presence of underlying clinically significant alloantibodies in a patient’s plasma or serum. These autoantibodies are problematic when performing laboratory procedures such as ABO typing, red blood cell (RBC) crossmatching, antibody detection testing, and antibody identification. To avert the masking of clinically significant alloantibodies in a patient’s plasma or serum, adsorption studies can be performed at 4°C using autologous RBCs

Ernest M. Ekema

Immunohematology, Volume 34 , ISSUE 4, 158–160

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

Article | 09-November-2020

A clinically significant anti-HLA-A2 detectable by extended incubation cytotoxicity and flow cytometric techniques but not by a standard NIH lymphocytotoxicity test

Stephen F. Garner, John Petrochilos, Colin J. Brown, Suzette Cavanna, I. Chanarin, Cristina Navarrete

Immunohematology, Volume 13 , ISSUE 2, 49–53

Article | 14-October-2020

Selecting an acceptable and safe antibody detection test can present a dilemma

The Transfusion Service at Duke University Hospital has changed antibody detection methods from the use of albumin in indirect antiglobulin tests to low-ionic-strength solution (LISS), and from LISS to polyethylene glycol (PEG) in an effort to enhance the rapid detection of clinically significant antibodies. In 1996, staffing issues required the consideration of automation. Although previous studies indicated that the gel test was not as sensitive as PEG for detection of clinically significant

Martha Rae Combs, Steven J. Bredehoeft

Immunohematology, Volume 17 , ISSUE 3, 86–89

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

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

Immunohematology, Volume 7 , ISSUE 4, 102–106

Article | 14-October-2020

Antibodies detected in samples from 21,730 pregnant women

Although anti-D is still the main cause of HDN, many other antibodies have been implicated. From September 1995 to April 2000,screening for RBC antibodies was performed on samples from 21,730 pregnant women regardless of RhD type. Standard tube and gel methods were used. Anti-D was identified in 254 samples;other antibody specificities were detected in 376 samples, for a total of 630 antibodies. For this study, 522 antibodies were considered clinically significant. The incidence of potentially

Snezana Jovanovic-Srzentic, Milan Djokic, Nenad Tijanic, Radmila Djordjevic, Nada Rizvan, Darko Plecas, Dejan Filimonovic

Immunohematology, Volume 19 , ISSUE 3, 89–92

Review | 02-May-2020

Review: the Kell, Duffy, and Kidd blood group systems

After the discovery (over 50 years ago) that the IAT could be applied to the detection of antibodies to blood group antigens, there was a rapid increase in the identification of alloantibodies that caused transfusion reactions or HDN. After Rh, antibodies in the Kell, Duffy, and Kidd blood group systems were the next in clinically significant antibodies to be revealed. Much of what has been learned about these blood groups since the journal Immunohematology issued its first edition has to do

Constance M. Westhoff, Marion E. Reid

Immunohematology, Volume 20 , ISSUE 1, 37–49

Article | 14-October-2020

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

tested by 2SP were reactive only by the 2SP test. Overall, the 2SP test detected only 0.6% of antibodies considered to be clinically significant (10 examples of anti-c and 2 examples of anti-e). The slight additional safety provided by detection of clinically-significant antibodies is overshadowed by the high number of clinically-insignificant antibodies detected by the 2SP test.

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

Immunohematology, Volume 17 , ISSUE 4, 122–124

Review | 16-October-2019

A brief overview of clinical significance of blood group antibodies

can occur via exposure to foreign (donor) RBC antigens through previous transfusions, transplants, or exposure to fetal RBCs during or after pregnancy. However, not all blood group antibodies are clinically significant. Clinically significant blood group antibodies can cause adverse events after blood component transfusion or transplantation and/or can cause hemolytic disease of the fetus and newborn.

Manish J. Gandhi, D. Michael Strong, Barbee I. Whitaker, Evangelia Petrisli

Immunohematology, Volume 34 , ISSUE 1, 4–6

Case report | 01-April-2020

Red blood cell transfusion in a patient with anti-AnWj: a case report

Anti-AnWj (Anton) has been associated with clinically significant hemolytic transfusion reactions. More than 99 percent of studied populations have RBCs that express the antigen. Reported here is a patient with anti-AnWj who was transfused with antigen-positive RBCs without adverse reaction.

Robert E. Stowers, Elie M. Richa, James R. Stubbs, S. Breanndan Moore

Immunohematology, Volume 23 , ISSUE 2, 55–58

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 | 22-November-2020

Case reports: use of a polyethylene glycol additive to enhance eluate sensitivity

The use of polyethylene glycol additives to enhance the detection of clinically significant alloantibodies in serum has been widely described. This report outlines several cases in which polyethylene glycol additives were added to eluate test systems to enhance the detection of alloantibodies in recently transfused patients.

Nancy A. Lang

Immunohematology, Volume 10 , ISSUE 1, 19–21

Case report | 09-October-2019

Acute hemolytic transfusion reaction attributed to anti-Ata

Anti-Ata is a rare alloantibody that can be clinically significant. We report a case of a woman who, after emergency-released uncrossmatched red blood cell transfusion, experienced an acute hemolytic transfusion reaction attributed to anti-Ata. The case presented herein highlights the importance of recognizing that anti-Ata may indeed cause acute hemolytic reactions.

Jay S. Raval, Sarah K. Harm, Bethann Wagner, Darrell J. Triulzi, Mark H. Yazer

Immunohematology, Volume 32 , ISSUE 4, 140–142

Review | 01-December-2019

Cartwright blood group system review

The Cartwright (Yt) blood group system consists of two antigens, Yta and Ytb, that result from point mutations in the acetylcholinesterase gene on chromosome 7q. Yta is a highincidence antigen, whereas its antithetical antigen, Ytb, shows much lower incidence. Anti-Yta and anti-Ytb are relatively rare. Anti-Yta is more commonly found in individuals of Jewish descent. Cartwright antibodies are rarely clinically significant; however, cases of in vivo hemolysis have been reported, suggesting that

Melissa R. George

Immunohematology, Volume 28 , ISSUE 2, 49–54

Report | 01-December-2019

Seroprevalence of unexpected red blood cell antibodies among pregnant women in Uganda

evidence of agglutination. Nine of the 21 samples demonstrated the presence of clinically significant RBC antibodies with anti-S being the most common, 8 samples demonstrated the presence of benign or naturally occurring antibodies, and 4 had only inconclusive reactivity. This study revealed a relatively high frequency of D and a low frequency of demonstrable clinically significant alloantibodies that may cause hemolytic disease of the newborn or hemolytic transfusion reactions among pregnant women in

Kristina Eipl, Clemensia Nakabiito, Kabali Bwogi, Mahnaz Motevalli, Angela Roots, Lorraine Blagg, J. Brooks Jackson

Immunohematology, Volume 28 , ISSUE 4, 115–117

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 | 15-February-2021

An update on the Knops blood group system

J.M. Moulds

Immunohematology, Volume 35 , ISSUE 1, 16–18

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

Article | 17-February-2021

Elimination of HLA antibodies by platelet adsorption

Introduction HLA antibodies are often a nuisance in antibody investigation and compatibility testing. These antibodies are often found in samples from multiply transfused patients who are refractory to platelet transfusion. They are common in multiparous women and can also develop spontaneously. Before the introduction of leukocyte reduction, HLA antibodies were known as a major cause of febrile transfusion reactions.1 HLA antibody reactivity may mask the presence of clinically significant red

J. Jung, C. Barron

Immunohematology, Volume 36 , ISSUE 1, 1–3

Review | 16-October-2019

A review of in vitro methods to predict the clinical significance of red blood cell alloantibodies

This review was derived from a presentation made on September 2, 2016, for the first Academy Day presented by the Working Party on Immunohematology at the International Society of Blood Transfusion (ISBT) Congress in Dubai. The focus of this review is on the clinical significance of alloimmunization in transfusion—specifically, the parameters that contribute to a clinically significant alloantibody. The areas of focus were as follows: Introduction, Technical Aspects, and Indications and

Sandra J. Nance

Immunohematology, Volume 34 , ISSUE 1, 11–15

Article | 17-November-2020

Correlation of monocyte monolayer assays and posttransfnsion survival of Yt(a+) red cells in patients with anti-Yta

significance of anti-Yta when samples for analysis were collected at least six weeks after initial detection ofthe antibody. Only 18.2 percent of those examples of anti-Yta tested appeared to be clinically significant.

Robert J. Eckrich, Delores M. Mallory, S. Gerald Sandler

Immunohematology, Volume 11 , ISSUE 3, 81–84

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

Report | 16-October-2019

Method-specific and unexplained reactivity in automated solid-phase testing and their association with specific antibodies

The inherent tradeoff between sensitivity and specificity in the detection of unexplained antibodies has been the objective of many studies, editorials, and journal articles. Many publications note that no method is capable of detecting all clinically significant antibodies while avoiding all clinically insignificant antibodies. This study describes the frequency of nonspecific reactivity and unexplained reactivity in solid-phase testing, along with the subsequent development of specific

Mary E. Harach, Joy M. Gould, Rosemary P. Brown, Tricia Sander, Jay H. Herman

Immunohematology, Volume 34 , ISSUE 3, 93–97

Article | 17-November-2020

A simple screening method to evaluate the presence of alloantibodies with concomitant warm autoantibodies

and allogeneic adsorption. In 42 percent of the cases, all autoantibody reactivity was removed by both methods. No clinically significant alloantibodies were missed using serum dilution as compared to allogeneic adsorptions. We conclude that serum dilution is a simple, rapid way to initially assess tor the presence of alloantibodies that co-exist with autoantibodies.  

Ragnhild Øyen, Maria L. Angeles

Immunohematology, Volume 11 , ISSUE 3, 85–87

Article | 30-November-2019

Inhibition of blood group antibodies by soluble substances

K.M. Byrne, C.M.C. Mercado, T.N. Nnabue, T.D. Paige, W.A. Flegel

Immunohematology, Volume 35 , ISSUE 1, 19–22

Article | 18-October-2020

Significant ABO hemolytic disease of the newborn in a group B infant with a group A2 mother

ABO hemolytic disease of the newborn (HDN) occurs almost exclusively in infants of blood group A or B who are born to group O mothers because IgG anti-A or -B occurs more commonly in group O than in group A or B individuals. We report a case in which clinically significant ABO-HDN occurred in a group B neonate from anti-B of a group A2 mother. The IgG anti-B titer was much higher (256) than that found in a group A1 mother/infant control group (≤ 32). The maternal antibody screen was negative

Hye-Ran Jeon, Beverly E.W. Calhoun, Mohammad Pothiawala, Marguerite Herschel, Beverly W. Baron

Immunohematology, Volume 16 , ISSUE 3, 105–108

Case report | 16-October-2019

A delayed and acute hemolytic transfusion reaction mediated by anti-c in a patient with variant RH alleles

The Rh system is the most complex of the human blood groups. Of the 55 antigens that have been characterized, the system’s principal antigens D, C, E, c, and e are responsible for the majority of clinically significant Rh antibodies. In the last few years, advancements in molecular testing have provided a wealth of information on the genetic diversity of the Rh locus. This case report describes a patient with variant RHD*DAR alleles inherited in conjunction with two compound heterozygote

Tiffany K. Walters, Thomas Lightfoot

Immunohematology, Volume 34 , ISSUE 3, 109–112

Article | 14-October-2020

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

, Kpa, and Wra.There are no data to support the considerable expense and effort involved in providing RBCs that possess low-frequency antigens such as Cw, Kpa, and Wra. The risk of clinically-significant hemolytic transfusion reactions occurring when such antibodies are not detected because antibody detection RBCs lack such antigens is about 1 in 500,000 to 1 in 1 million transfusions.

George Garratty

Immunohematology, Volume 18 , ISSUE 3, 71–77

Report | 01-December-2019

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

Our facility changed antibody screening methods from a gel microcolumn–based test (ID-Micro Typing System Gel Test; Ortho Clinical Diagnostics, Inc., Raritan, NJ) to an automated solid-phase test (Galileo/Capture-R Ready-Screen [I and II], Immucor, Inc., Norcross, GA). To determine whether detection rates for commonly encountered clinically significant red blood cell antibodies differed as a consequence of this change, preimplementation and postimplementation antibody identification

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

Immunohematology, Volume 29 , ISSUE 3, 101–104

Case report | 01-December-2019

An AQP1 allele associated with Co(a–b–) phenotype

deletion of a G at nucleotide 601 (nt601delG) that results in a frameshift and premature termination (Val201Stop). Available family members were tested for the allele. Although anti-Co3 has been associated with mild to severe hemolytic disease of the fetus and newborn, the antibody was not clinically significant as evidenced by a low titer and delivery of asymptomatic newborns with moderate to weakly positive direct antiglobulin tests for all four pregnancies.

Sunitha Vege, Sandra Nance, Donna Kavitsky, Xiaojin Li, Trina Horn, Geralyn Meny, Connie M. Westhoff

Immunohematology, Volume 29 , ISSUE 1, 1–4

Case report | 01-December-2019

Alloimmunization to Kell blood group system antigen owing to unmatched blood transfusion in a resource-poor setting

blood in multiply transfused patients with thalassemia. This can prevent the development of antibodies against these clinically significant antigens, as antibodies can cause severe acute or delayed hemolytic transfusion reactions and create difficulties in providing a crossmatch-compatible packed red blood cell unit. The policy should preferably be adopted irrespective of financial constraints as it will pave the way for better transfusion practices and reduce the risk of adverse reactions in

Sheetal Malhotra, Gagandeep Kaur, Sabita Basu, Ravneet Ravneet, Geetanjali Jindal

Immunohematology, Volume 28 , ISSUE 2, 45–48

Review | 20-March-2020

MNS blood group system: a review

The MNS blood group system is second only to the Rh blood group system in its complexity. Many alloantibodies to antigens in the MNS system are not generally clinically significant although antibodies to low-prevalence and high-prevalence MNS antigens have caused hemolytic disease of the fetus and newborn. The MNS antigens are carried on glycophorin A (GPA), glycophorin B (GPB), or hybrids thereof, which arise from single-nucleotide substitution, unequal crossing over, or gene conversion

Marion E. Reid

Immunohematology, Volume 25 , ISSUE 3, 95–101

Article | 01-April-2020

Management of pregnancy complicated by anti-hrB/anti-HrB

Anti-hrB and anti-HrB are rare alloantibodies found predominantly in people of BlackAfrican descent. It has been assumed that strongly reacting examples of anti-hrB may cause hemolytic transfusion reactions,but precise information is limited. Anti-HrB is a clinically significant antibody and may cause hemolytic transfusion reactions and HDN. Selection of blood for transfusion support for patients with these alloantibodies, and especially with anti-HrB, imposes a special challenge in the United

Nay Win, Malcolm Needs, Louise Tillyer

Immunohematology, Volume 23 , ISSUE 4, 143–145

Article | 06-December-2020

Clinical correlation of positive direct antiglobulin tests in patients with sickle cell disease

Serologic findings of immune-mediated hemolytic anemia (autoimmune hemolytic anemia and cold agglutinin disease) are not infrequent in patients with sickle cell disease and can be clinically significant. Features of sickle cell disease that may affect the emergence and intensity of immune-mediated hemolysis include the antigenic stimulation of chronic red blood cell (RBC) transfusions, increased autoantibody production, RBC membrane defects, and functional asplenism. We describe two patients

Raymond L. Comenzo, Marie E. Malachowski, Eugene M. Berkman

Immunohematology, Volume 8 , ISSUE 1, 13–16

Article | 16-February-2021

Use of trypsin in serologic investigation

trypsin treatment of RBCs in the antibody identification process include the inability to provide rule-outs, panagglutination, and inconsistent reactivity with treated RBCs. If the antibody to the high-prevalence antigen is not destroyed by trypsin, a negative reaction will not be achieved, preventing the rule-outs of common clinically significant alloantibodies. As in all enzyme treatments, treatment can expose enzyme-specific antigens present in most normal sera resulting in panagglutination

A. Novotny

Immunohematology, Volume 35 , ISSUE 4, 145–148

Review | 16-October-2019

Clinical significance of antibodies to antigens in the Scianna, Dombrock, Colton, LandsteinerWeiner, Chido/Rodgers, H, Kx, Cromer, Gerbich, Knops, Indian, and Ok blood group systems

survival of transfused antigen-positive red blood cells or a transfusion reaction (e.g., anti-Ge2, anti-H) and/or hemolytic disease of the fetus and newborn (e.g., anti-Coa , anti-Ge3)— has been documented. Some of these antibodies are not always clinically significant, and because of the high prevalence of the antigen, antigen-negative blood may be extremely difficult to find (e.g., anti-LW, anti-Inb). The use of a monocyte monolayer assay may be helpful when making transfusion decisions for

Sofia Lejon Crottet

Immunohematology, Volume 34 , ISSUE 3, 103–108

Article | 15-April-2020

In search of the Holy Grail: comparison of antibody screening methods

Currently,the goal of testing for RBC antibodies is to use a method that will detect, if possible, all antibodies that are considered clinically significant and yet not detect antibodies of little clinical importance in transfusion or pregnancy. The focus of test method development has been on the more controllable variables of the first and second stages of agglutination. Tube test methods have been developed over the years to achieve shorter turnaround times for quicker test results and

Tony S. Casina

Immunohematology, Volume 22 , ISSUE 4, 196–202

Article | 30-November-2020

Hemolytic transfusion reactions due to anti-e+f detectable only by nonstandard serologic techniques

patient subsequently received leukocyte-depleted group A, cDE/cDE RBCs without any untoward effect. This case demonstrates the importance of a complete transfusion history and emphasizes that alloantibodies detectable only by nonstandard techniques can be clinically significant.

Alan Devenish, Lesley A. Kay

Immunohematology, Volume 10 , ISSUE 4, 120–123

Article | 14-October-2020

Antibody screening in 37°C saline. Is it safe to omit it using the indirect antiglobulin (gel) test?

Pretransfusion tests must detect antibodies that can shorten the life of red blood cells (RBCs). Some studies have demonstrated the existence of clinically significant antibodies detected at 37°C in saline that are not detected by the indirect antiglobulin test (IAT) when the conventional tube test is used. Our aim was to determine whether these antibodies, detected with a 37°C saline tube test, are also detected when a sensitive column gel agglutination method is used. The 2373

José A. Duran, Manuel Figueiredo

Immunohematology, Volume 18 , ISSUE 1, 13–15

Article | 15-August-2021

Effects of the Herbst appliance in growing orthodontic patients with different underlying vertical patterns

its use will be associated with clinically significant forward rotation in dolichofacial subjects. Since dolichofacial patterns are likely to remain long-faced, even after considerable Class II dental correction, orthognathic surgery may still be a consideration if normal facial proportions, without excessive facial convexity and lip strain, are treatment aims.

Emily Deen, Michael G. Woods

Australasian Orthodontic Journal, Volume 31 , ISSUE 1, 59–68

Article | 15-April-2020

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

Patients with sickle cell disease (SCD) typically require transfusions with RBC components,which exposes them to numerous,possibly foreign antigens and potentially causes them to produce an antibody or antibodies to the antigens they lack. As transfusion of these patients increases, the likelihood that they will produce an initial antibody or additional antibodies increases. Once a clinically significant antibody is produced, units of RBCs that lack the associated antigen should be transfused

Cynthia Flickinger

Immunohematology, Volume 22 , ISSUE 3, 136–142

Article | 18-October-2020

Comparison of tube and gel techniques for antibody identification

antibodies (2 with anti-K), and 8 other antibody specificities. Based on this study, the gel test is more sensitive (p <.01) than the tube test for identifying potentially clinically significant antibodies.

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

Article | 14-October-2020

Tube and column agglutination technology for autocontrol testing

clinically significant antibody, anti-D. Moreover, the same sample also tested positive in all three methods. Column agglutination techniques have increased sensitivity for a positive autocontrol beyond the conventional tube method. However, ReACT and gel tests differ significantly in their frequency of positives. Investigation of the significance of a positive autocontrol in column agglutination technology when the conventional tube method is also positive is suggested.

J.E. Courtney, J.L. Vincent, A.J. Indrikovs

Immunohematology, Volume 17 , ISSUE 2, 50–52

Article | 10-April-2021

Acute hemolytic transfusion reaction caused by anti-Yta

of anti-Yta suggested it to be a clinically significant antibody concerning transfusion, some patients with anti-Yta received Yt(a+) blood without apparent reaction.4,15 In the report by Eaton et al.,4 anti-Yta was detected in the patient 4 days after a second series of transfusions. Although there was a weakly positive DAT 60 days after transfusion, it was concluded that Yt(a+) RBCs were still present and that anti-Yta did not reduce the survival of transfused RBCs.4 Dobbs et al.15 studied one

M. Raos, N. Thornton, M. Lukic, B. Golubic Cepulic

Immunohematology, Volume 37 , ISSUE 1, 13–17

Article | 30-July-2021

The Herbst appliance and the Activator: influence of the vertical facial pattern

: Clinically significant dental and skeletal changes (including mandibular incisor proclination and overjet reduction) were characteristics of both treatment methods. Any increases in mandibular length and chin prominence were not greater than those expected following natural growth. The pretreatment VFP remained essentially unaltered, while mean changes as a result of treatment were similar for brachyfacial, mesofacial, and dolichofacial subjects. No predictive factors were identified. Conclusions

Christopher Turnock, Michael G. Woods

Australasian Orthodontic Journal, Volume 32 , ISSUE 2, 130–138

research-article | 30-November-2020

Quantitative assessment of interproximal tooth reduction performed as part of Invisalign® treatment in 10 orthodontic practices

anterior 1,131 0.31 (0.12) 0.13 (0.16) 0.18 43.37 Md posterior 422 0.26 (0.15) 0.13 (0.17) 0.13 48.80 Although the mean achieved IPR ranged in the groups from 37.1 to 58.8%, there was a surprising consistency, with most groups close to the overall mean of 44.0%. There were statistically significant differences between the Anterior and Posterior groups (p < 0.01) and between Mx Anterior and Mx Posterior groups (p < 0.01), however, these could not be considered clinically significant with mean

Tony Weir, Arun Shailendran, Brett Kerr, Elissa Freer

Australasian Orthodontic Journal, Volume 37 , ISSUE 2, 176–186

Report | 25-March-2020

The potential of blood group genotyping for transfusion medicine practice

assays are reproducible and highly correlated with the RBC phenotype.  The recent availability of automated, highthroughput, DNA-array platforms now moves testing from the reference laboratory setting into hospital and donor testing centers.  This approach has the potential to revolutionize the process of locating antigen-negative donor units by testing for all clinically significant blood group antigens in a single assay.  When partnered with the same extended typing of the patient

Connie M. Westhoff

Immunohematology, Volume 24 , ISSUE 4, 190–195

Article | 14-December-2020

Determining the significance of anti-K1 in hemolytic disease of the newborn (HDN)

Anti-K1 is capable of causing severe hemolytic disease of the newborn (HDN), but few cases are seen due to the low frequency of the antigen. A total of 1,215 pregnancies from 1962 to 1989 were reviewed. There were 404 non-anti-D clinically significant antibodies, of which 103 (25%) were anti-K1. Anti-K1 was detected in nine of the women at delivery, of whom two had antigen-positive infants who were clinically unaffected. Antigen typing was done on 64 of the 85 fathers. Forty-seven were K: - 1

Patricia L. Strohm, Janice F. Blazina, Richard W. O'Shaughnessy, Melanie S. Kennedy, Jane M. Moore

Immunohematology, Volume 7 , ISSUE 2, 40–42

Article | 17-February-2021

Identification of rare blood types in southern Brazil: impact on transfusion support

-) S- 0 5 rr K- Fy(a-) Jk(b-) s- 4 1 rr K- Fy(b-) Jk(a-) S- 0 1 rr K- Fy(b-) Jk(a-) s- 0 2 rr K- Fy(b-) Jk(b-) S- 1 2 rr K- Fy(b-) Jk(b-) s- 0 3 Regarding the packed RBC units transfused in the 17 patients with rare phenotypes, 6 of them had never received a previous transfusion. Among the 11 transfused patients, there was a variation between 1 and 28 RBC units transfused, and 6 of these patients had one or more clinically significant RBC antibodies. Discussion In the present study

C.D.S.R. de Araújo, B.A. Machado, C.D. Reche, L. Maroni, L.C. Garlet, M.M.P. dos Santos, M. Beber, A. Pasqualotti, L. Castilho

Immunohematology, Volume 36 , ISSUE 4, 152–156

Review | 31-January-2019

The use of ultrasound-guided platelet-rich plasma injections in the treatment of hip osteoarthritis: a systematic review of the literature

. The platelet-rich plasma recipient group included 61 males and 54 females with an age range from 53 to 71 years. Outcome scores show an improvement of symptoms and function maintained up to 12 months following platelet-rich plasma injection. Conclusions: Literature to date concludes that intra-articular platelet-rich plasma injections of the hip, performed under ultrasound guidance to treat hip osteoarthritis, are well tolerated and potentially efficacious in delivering long-term and clinically

Mohammed Ali, Ahmed Mohamed, Hussam Elamin Ahmed, Ajay Malviya, Ismael Atchia

Journal of Ultrasonography, Volume 18 , ISSUE 75, 332–337

Case report | 09-October-2019

Two cases of the variant RHD*DAU5 allele associated with maternal alloanti-D  

Rh is a complex blood group system with diverse genotypes that may encode weak and partial D variants. Standard serologic analysis may identify clinically significant D variants as D+; nevertheless, individuals with these D variants should be managed as D– patients to prevent antibody formation to absent D epitopes. Variant identification is necessary during pregnancy to allow for timely and appropriate Rh immune globulin (RhIG) prophylaxis for hemolytic disease of the fetus and newborn

Jennifer A. Duncan, Susan Nahirniak, Rodrigo Onell, Gwen Clarke

Immunohematology, Volume 33 , ISSUE 2, 60–63

Case report | 16-October-2019

Management of pregnancy sensitized with anti-Inb with monocyte monolayer assay and maternal blood donation

community blood supply. Involvement of obstetric, transfusion medicine, anesthesia, and neonatology providers was imperative for a favorable outcome. The antibody did not cause clinically significant anemia in this infant.

Raj Shree, Kimberly K. Ma, Lay See Er, Meghan Delaney

Immunohematology, Volume 34 , ISSUE 1, 7–10

Article | 20-July-2021

Accuracy of orthognathic surgery using 3D computer-assisted surgical simulation

potential for clinically significant errors to occur on an individual basis.

Richard Lee, Mithran S. Goonewardene, Ajmal Mian, Brent Allan, Danny Brock, Michelle Trevenen

Australasian Orthodontic Journal, Volume 34 , ISSUE 1, 17–26

Report | 01-December-2019

Should blood donors be routinely screened for irregular antibodies?

Alloantibody reactivity is approximately 0.3 percent in blood donors worldwide. The present study established total alloantibody and clinically significant alloantibody (CSAA) frequencies in all Colombian Red Cross National Blood Bank donors (almost all donors were Colombian). The probability of these alloantibodies reacting with a specific antigen in the general population was also determined, focusing on male CSAA data because routine practice in this blood bank is to discard female plasma

Michel Andrés García, Leonardo Bautista, Fernando Palomino

Immunohematology, Volume 28 , ISSUE 2, 60–66

Article | 20-July-2021

An in vivo spectrophotometric evaluation of Vivera® and Essix® clear thermoplastic retainer discolouration

Essix® retainers exhibited similar colour stability. All differences observed were considered clinically acceptable (ΔE < 3.7), although prolonged use could cause clinically significant colour changes.

Anastasios A. Zafeiriadis, Andreas Karamouzos, Athanasios E. Athanasiou, Theodore Eliades, George Palaghias

Australasian Orthodontic Journal, Volume 34 , ISSUE 1, 3–10

Article | 15-May-2020

The sensitivity, specificity, and clinical relevance of gel versus tube DATs in the clinical immunology laboratory

of 310 cases the DAT was negative by both methods. Of the 42 patients with a positive DAT, the test was positive by both methods in 18 patients. In the remaining 24 cases the DAT was positive by the gel test only.In all cases positive by both techniques the test result affected patient management. Of the 24 cases that were positive only by gel test, 3 were judged to be clinically significant. In this study, the gel test was more sensitive than the tube technique for performance of the DAT.However

Na’ama Paz, Dganit Itzhaky, Martin H. Ellis

Immunohematology, Volume 20 , ISSUE 2, 118–121

Article | 14-October-2020

Significance of platelet-reactive antibody screening for patients facing frequent platelet transfusions

It is not clear whether platelet-reactive antibody screening is clinically significant for patients facing frequent platelet transfusions. On the basis of data from 96 patients who had been examined for platelet-reactive antibodies by the mixed passive hemagglutination method for a variety of reasons, we investigated the following three issues retrospectively: (1) the relationship between platelet-reactive antibodies and the occurrence of problems in platelet transfusions, such as

Tetsunori Tasaki, Kieko Fujii, Kenji Gotoh, Shyukuko Satoh, Jyunko Takadate, Sakiko Sasaki, Mihoko Tachibana, Kimiko Yamamoto

Immunohematology, Volume 18 , ISSUE 4, 104–108

Article | 03-November-2020

Implementation of gel column technology, including comparative testing of Ortho ID-MTS with standard polyethylene glycol tube tests

techniques were evaluated by GEL. These samples included 49 that were nonreactive and 17 with a positive antibody detection test. Within the latter were 19 antibodies, 17 with specificities considered to be clinically significant and 2 usually considered clinically insignificant for red cell transfusion. GEL was nonreactive with the 49 PEG negative samples as well as with the 2 samples containing insignificant antibody. All 17 antibodies of probable clinical significance were detected. Antibody

Diane A. Derr, Stacy J. Dickerson, E.Ann Steiner

Immunohematology, Volume 14 , ISSUE 2, 72–74

Article | 29-December-2020

Assessing the clinical significance of anti-Cra and anti-M in a chronically transfused sickle cell patient

long-term survival of the donor’s red cells with only 60.1 percent recovery at six days (T 1/2 = 12 days) and 10.8 percent at 14 days (T 1/2 = 4.5 days). A monocyte-monolayer assay (MMA) indicated that both the anti-Cra (5.9%) and anti-M (18%) would probably be clinically significant (normal value 0-3%). Mass screening continues at several blood centers for Cr(a -), M -, E -, K-, S-, Fy(a - b -) donors. However, if no suitable donors are found, the results of the 51chromium sur­vival

Mary B. Leatherbarrow, Sandra S. Ellisor, Patricia A. Collins, Deborah K. Douglas, Robert J. Eckrich, Susan S. Esty, Michael L. Baldwin, Paul M. Ness

Immunohematology, Volume 4 , ISSUE 4, 71–74

Article | 17-February-2021

A prospective, observational study for optimization of antibody screening in pretransfusion compatibility testing

clinically significant antibody is detected in a patient, it is important to provide corresponding antigen-negative units to this patient. The TS approach in pretransfusion testing was approved by the U.S. Food and Drug Administration and AABB in 1984, and this approach has been strongly recommended.1–3 The first few reports in the literature about the TS approach were published thereafter, establishing that RBC units can be safely transfused without AHG crossmatch in AS– patients. None of the patients

P. Pandey, D. Setya, R. Srivastava, M.K. Singh

Immunohematology, Volume 36 , ISSUE 1, 19–28

Article | 16-February-2021

Comparison of ABO genotyping methods: a study of two low-resolution polymerase chain reaction assays in a clinical testing laboratory

J.A. Keller, T. Horn, S. Scholz, S. Koenig, M.A. Keller

Immunohematology, Volume 35 , ISSUE 4, 149–153

Case report | 26-October-2019

Anti-Jk3 in a Filipino man

laboratory for further testing. Results from the reference lab testing revealed the presence of anti-Jk3 in the patient’s serum. The patient was placed on steroids, and his reticulocyte count increased with no further signs of extravascular hemolysis. No additional transfusions were necessary. He was eventually discharged with a hemoglobin of 13.6 g/dL. The purpose of this case study is to report the findings of an extremely rare but clinically significant antibody, anti-Jk3.

Shaina McCaskill, Scott Wise, Sheila Tinsley

Immunohematology, Volume 31 , ISSUE 3, 119–122

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