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Article | 16-February-2021

Dilution is not the solution: acute hemolytic transfusion reaction after ABO-incompatible pooled platelet transfusion

intrinsic antibodies of the respective donor(s), including anti-A, anti-B, and anti-A,B depending on their ABO blood group. Real-world constraints on platelet inventory often make selection of platelet units challenging, and many institutions opt to issue ABO-incompatible platelets if compatible units are not available. According to the 2007 College of American Pathologists Transfusion Medicine Proficiency Testing Survey, in the United States, approximately 74 percent of laboratories have policies that

J. Guarente, M. Harach, J. Gould, J.K. Karp, A.R. Peedin

Immunohematology, Volume 35 , ISSUE 3, 91–94

Case report | 27-April-2020

Case report: massive postpartum transfusion of Jr(a+) red cells in the presence of anti-Jra

Jra is a high-prevalence antigen. The rare Jr(a–) individuals can form anti-Jra after exposure to the Jra antigen through transfusion or pregnancy. The clinical significance of anti-Jra is not well established. This study reports a case of a 31-year-old woman with a previously identified anti-Jra who required massive transfusion of RBCs after developing life-threatening postpartum disseminated intravascular coagulopathy. Despite the emergent transfusion of 15 units of Jra untested RBCs

Shan Yuan, Rosalind Armour, Allison Reid, Khaled F. Abdel-Rahman, Michael Phillips, Dawn M. Rumsey, Theresa Nester

Immunohematology, Volume 21 , ISSUE 3, 97–101

Case report | 09-October-2019

Hemolytic transfusion reaction attributable to anti-Dia  

In situations when a patient's antibody detection test is negative, many institutions have moved from an indirect antiglobulin test (IAT) crossmatch to an electronic crossmatch system. Here we report a case of an acute hemolytic transfusion reaction attributable to anti-Dia in a patient with a negative antibody detection test. A 22-year-old female patient with a diagnosis of β thalassemia and sickle cell anemia commenced a routine exchange transfusion of 5 units of red blood cells

Arthur J. Joyce, Kelli M Quantock, Ray Banh, Yew-Wah Liew

Immunohematology, Volume 33 , ISSUE 1, 6–8

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

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

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 | 10-April-2021

Acute hemolytic transfusion reaction caused by anti-Yta

The Yta antigen is part of the Cartwright blood group system (YT). The YT system is the 11th human blood group system recognized by the International Society of Blood Transfusion (ISBT 011), which now includes five antigens: one pair of antithetical antigens, Yta and Ytb, and three additional high-prevalence antigens (HPAs): YTEG, YTLI, and YTOT.1 YT antigens are found on the glycosylphosphatidylinositol-linked red blood cell (RBC) glycoprotein acetylcholinesterase (AChE), which plays an

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

Immunohematology, Volume 37 , ISSUE 1, 13–17

Report | 24-March-2020

Automation in the transfusion service

Several instruments are now available for full automation of serologic testing in the transfusion service.  Selection of an instrument is based on the facility’s needs for testing and its resources.  Installation, validation, interfacing, and operations require new skill sets for most transfusion service personnel.  The newer instruments are suitable for use in smaller transfusion services, where procedures may not have changed recently and installing new equipment is a

Suzanne H. Butch

Immunohematology, Volume 24 , ISSUE 3, 86–92

Article | 18-October-2020

Improving transfusion safety by electronic identification of patients, blood samples, and blood units

To evaluate the feasibility of using an electronic identification system to improve safety and documentation of blood transfusions, a handheld bar code scanner and data terminal, portable label printer, and related software were integrated into all phases of the blood transfusion process, including sample collection, laboratory testing, and administration of blood components. The study was conducted in two hospitals, one in Italy and the other in the United States. Each hospital used different

Maurizio Marconi, Girolamo Sirchia, S. Gerald Sandler, Albert F. Langeberg

Immunohematology, Volume 16 , ISSUE 2, 82–85

Case report | 09-October-2019

Postpartum acute hemolytic transfusion reactions associated with anti-Lea in two pregnancies complicated by preeclampsia

Lewis blood group antibodies, which are mostly naturally occurring and considered clinically insignificant, have rarely been documented as a cause of acute hemolytic transfusion reactions (AHTRs). This report presents two cases of AHTRs caused by anti-Lea occurring in postpartum black females (one group B, one group AB) whose pregnancies were complicated by preeclampsia. Neither anti-Lea was detected by automated solid-phase red cell adherence technology in pre-transfusion testing. Therefore

Marcia Marchese

Immunohematology, Volume 33 , ISSUE 3, 114–118

Report | 24-March-2020

Transfusion service disaster planning

needs during a crisis, including the need for blood and transfusion medicine services.  The MEICS plan was developed to supplement our current local emergency preparedness procedures and provide a mechanism for responding to the escalating severity of an emergency to deal with situations of a magnitude that is outside the normal experience.  A plan was developed to interface the existing Transfusion Medicine disaster plan standard operating procedures (SOP) with the institutional and

Kevin L. Bundy, Mary L. Foss, James R. Stubbs

Immunohematology, Volume 24 , ISSUE 3, 93–101

Report | 16-March-2020

Transfusion of rare cryopreserved red blood cell units stored at -80°C: the French experience

more. However, the lack of nucleic acid testing for HIV and HCV may be problematic for old RBC units drawn from donors who were not subsequently tested for these markers, which is now mandatory in most countries. Regarding the 118 transfused RBC units older than 10 years, no evidence of hemolysis of thawed RBCs and no transfusion reaction, clinical or biologic hemolysis, or transfusion ineffectiveness was reported, either by any of the parties involved in the transfusion supply of rare RBC units or

Thierry Peyrard, Bach-Nga Pham, Pierre-Yves Le Pennec, Philippe Rouger

Immunohematology, Volume 25 , ISSUE 1, 13–17

case-report | 25-June-2021

B subgroup detection in a small hospital transfusion service

The ABO blood group system is the most clinically significant antigen system in transfusion medicine. The ABO gene is located on chromosome 9 and consists of seven exons. Exons 6 and 7 encode for the catalytic domain of the ABO glycosyltransferases. The A blood group is formed by the addition of N-acetyl-galactosamine to the H antigen, the B blood group is formed by the addition of galactose to the H antigen, and blood group O results when no sugar is added to the H antigen.1 ABO blood groups

E. Elardo, N. Elbadri, C. Sanchez, V. Powell, M. Smaris, Y. Li, J. Jacobson, T. Hilbert, T. Hamilton, D.W. Wu

Immunohematology, Volume 37 , ISSUE 2, 89–94

Article | 21-April-2020

Acute hemolytic transfusion reaction secondary to anti-Fy3

A hemolytic transfusion reaction due to anti-Fy3 is reported in an African American patient with no history of sickle cell disease. This 82-year-old African American woman received two units of RBCs for anemia (Hb 7g/dL) on admission for a left hip fracture. On hospital Day 7, the patient underwent left hip endoprosthesis surgery; she received two units of RBCs on the second postoperative day due to Hb of 6.1g/dL. Her urine was dark during surgery and postoperatively. Her posttransfusion plasma

Horatiu Olteanu, David Gerber, Kara Partridge, Ravindra Sarode

Immunohematology, Volume 21 , ISSUE 2, 48–52

Case report | 24-March-2020

Overt immediate hemolytic transfusion reaction attributable to anti-Wra

Wra is a low-prevalence antigen.  Anti-Wra is a relatively common antibody present in approximately 1 in 100 healthy blood donors.  Anti-Wra is reported to cause different degrees of hemolysis in transfusion and in HDN, ranging from benign to severe.  This report describes an acute overt hemolytic transfusion reaction in a patient whose serum contained anti-Wra and who received a Wr(a+) RBC component.

Fouad N. Boctor

Immunohematology, Volume 24 , ISSUE 3, 113–115

Case report | 26-October-2019

Suspected acute hemolytic transfusion reaction mediated by anti-Dia

Anti-Dia can mediate hemolytic disease of the fetus and newborn, but it is unclear if it can cause hemolytic transfusion reactions (HTRs). To date, there has only been one report of a possible immediate HTR attributed to anti-Dia. Our case report details an immediate HTR due to anti-Dia in a patient with pre-existing liver failure. This reaction triggered multi-organ failure, and the patient subsequently died. This case also highlights the importance of considering HTRs even when routine

Ashwini Bennett, Ray K. Boyapati, Frank S. Hong

Immunohematology, Volume 31 , ISSUE 4, 163–165

Article | 14-October-2020

Fatal hemolytic transfusion reaction due to anti-Ku in a Knull patient

A fatal transfusion reaction due to anti-Ku in a Knull (Ko) patient is reported. The patient was transfused with 34 units of incompatible RBCs during 44 days of hospitalization. Apart from the first transfusion, all subsequent transfusions failed to raise the patient’s Hb. No serum antibody was identified until he was transferred to another hospital for dialysis. A compatibility test demonstrated a weak antibody and autocontrol reacting at room temperature by a manual polybrene method

Marie Lin, Chang Lin Wang, Fu-Sen Chen, Li-Hwa Ho

Immunohematology, Volume 19 , ISSUE 1, 19–21

Report | 25-March-2020

The potential of blood group genotyping for transfusion medicine practice

Molecular diagnostics is the fastest growing area of clinical laboratory medicine.  The ability to rapidly amplify genes of bacterial, viral, or human origin, and the development of DNA array platforms, are driving a technology revolution in the clinical laboratory.  A DNA-based testing approach is particularly applicable to blood bank and transfusion medicine for rapid, cost-effective antigen typing.  Experience with DNA-based methods during the past decade has shown that these

Connie M. Westhoff

Immunohematology, Volume 24 , ISSUE 4, 190–195

Case Study | 16-May-2020

Delayed hemolytic transfusion reaction due to anti-Fyb caused by a primary immune response: a case study and a review of the literature

Delayed hemolytic transfusion reactions (DHTRs) usually occur between 3 and 14 days posttransfusion as a result of a secondary immune response, with a drop in Hb level, fever, jaundice, or hemoglobinuria. DHTRs caused by a primary immune response are particularly rare events,and only a few reports have been known. In this report, we describe an unusual case of a DHTR caused by anti-Fyb in a 42-year-old man, who had no prior history of transfusion. Although it seems to be a rare phenomenon, we

Hyung Hoi Kim, Tae Sung Park, Seung Hwan Oh, Chulhun L. Chang, Eun Yup Lee, Han Chul Son

Immunohematology, Volume 20 , ISSUE 3, 184–186

Article | 18-October-2020

Further characterization of transfusion-related acute lung injury: demographics, clinical and laboratory features, and morbidity

According to Food and Drug Administration data, transfusion-related acute lung injury (TRALI) is the third most frequent cause of transfusion-associated death in the United States and is characterized by an acute respiratory distress syndrome-like clinical picture following transfusion of plasma-containing blood components. It may be underdiagnosed due to unfamiliarity of clinicians with the syndrome. This report describes the largest series to date, 46 cases, occurring between 1992 and 1998

Mark A. Popovsky, N. Rebecca Haley

Immunohematology, Volume 16 , ISSUE 4, 157–159

Report | 01-December-2019

Directed blood donor program decreases donor exposure for children with sickle cell disease requiring chronic transfusion

In children with sickle cell disease (SCD), primary and secondary prevention of strokes require indefinite regular blood transfusion therapy. The risks associated with repeated transfusions include alloimmunization and increased donor exposure. The Charles Drew Program is a directed blood donor program designed to lower donor exposure, decreasing the associated complications of transfusion; however, no evidence exists demonstrating the magnitude of the benefit to the recipient. Further, the use

Dionna O. Roberts, Brittany Covert, Terianne Lindsey, Vincent Edwards, Lisa McLaughlin, John Theus, Ricardo J. Wray, Keri Jupka, David Baker, Mary Robbins, Michael R. DeBaun

Immunohematology, Volume 28 , ISSUE 1, 7–12

Review | 01-April-2020

Transfusion of multiple units of Js(b+) red blood cells in the presence of anti-Jsb in a patient with sickleβ-thalassemia disease and a review of the literature

Jsb is a high-frequency antigen.Anti-Jsb is a rare alloantibody,and its clinical significance is poorly documented. We report a case in which a 12-year-old boy of Nigerian descent with sickle βthalassemia presented with multiple alloantibodies, including a panagglutinin and acute chest syndrome, necessitating the emergent transfusion of five units of phenotype-similar,crossmatchincompatible RBCs,four of which were given during an exchange transfusion. The patient was later found to have

Shan Yuan, Nadia P. Ewing, Debra Bailey, Marissa Salvador, Shirong Wang

Immunohematology, Volume 23 , ISSUE 2, 75–80

Case report | 11-March-2020

An unusual case of an acute hemolytic transfusion reaction caused by an autoanti-I

In general, naturally occurring cold autoagglutinins react optimally at low temperatures. We describe a young child who experienced an acute hemolytic transfusion reaction by an unusual autoanti-I. The IgM autoanti-I was detected at 4°C (titer 256) and also reacted at 30°C. This case highlights the potential hazard of transfusing units of blood immediately upon removal from the blood refrigerator, especially into neonates and children of small stature.

Nay Win, Sally Rahman, Philip Gold, Susan Ward

Immunohematology, Volume 27 , ISSUE 3, 101–103

Case report | 09-October-2019

A suspected delayed hemolytic transfusion reaction mediated by anti-Joa

last transfused with red blood cells (RBCs) 2 years earlier, but had no history of transfusion reactions. Due to surgery, the patient’s hemoglobin (Hb) decreased from 10.2 g/dL (preoperative) to 8.6 g/dL (postoperative). One unit of weakly crossmatchincompatible Fy(a–), C–, E–, K–, and sickle cell hemoglobin S (HbS)-negative RBCs was transfused without incident, and the patient was discharged. Several days later, the reference lab reported two new specificities, anti

Ryan P. Jajosky, Wendy C. Lumm, Scott C. Wise, Roni J. Bollag, James F. Shikle

Immunohematology, Volume 33 , ISSUE 2, 73–75

Review | 18-May-2020

Review: IgA anaphylactic transfusion reactions. Part I. Laboratory diagnosis, incidence,and supply of IgAdeficient products

Despite yielding a definitive diagnosis in fewer than 20 percent of anaphylactic transfusion reactions, investigation for IgA deficiency and the presence of presumably pathogenic IgG anti-IgA is useful in patient management. Individuals with demonstrated anti-IgA are thereafter committed to receiving IgA-depleted cellular products or IgA-deficient plasma and derivatives to prevent recurrent severe reactions. Unfortunately, in populations of IgA-deficient individuals screened for anti-IgA, the

Ralph R. Vassallo

Immunohematology, Volume 20 , ISSUE 4, 226–233

Article | 16-February-2021

A case of platelet transfusion refractoriness due to anti-CD36 with a successful treatment outcome

CD36 is one of the many human platelet (PLT) antigens and glycoproteins that can be targeted in immune-mediated thrombocytopenias.1 Individuals with CD36 deficiency can develop anti-CD36, which can lead to PLT transfusion refractoriness.2 Two types of CD36 deficiency have been identified: complete lack of CD36 on PLTs and monocytes (type 1 deficiency) and lack of CD36 on PLTs with variable expression on monocytes (type 2 deficiency).3 The CD36-negative (CD36–) phenotype has mainly been reported

S.S. Khatri, B.R Curtis, C. Yamada

Immunohematology, Volume 35 , ISSUE 4, 139–144

Article | 14-October-2020

Acute hemolytic transfusion reaction caused by anti-Coa

Coa is a high-frequency blood group antigen in the Colton blood group system expressed on red blood cells (RBCs) of approximately 99.8 percent of random persons. Anti-Coa has been reported to cause delayed hemolytic transfusion reactions, hemolytic disease of the newborn, and accelerated clearance of RBCs in vivo. Acute hemolytic transfusion reactions (AHTRs) have not previously been reported. A 58-year-old man was hospitalized for vascular surgery. Initial blood bank evaluation revealed anti

Randal B. Covin, Karen S. Evans, Richard Olshock, Hannis W. Thompson

Immunohematology, Volume 17 , ISSUE 2, 45–49

Article | 10-April-2021

A fatal case of acute hemolytic transfusion reaction caused by anti-Wra: case report and review of the literature

Wra is the most common low-prevalence antigen (LPA) in the white population, and anti-Wra is the most common naturally occurring antibody.1 The first case of anti-Wra was described by Holman2 in 1953 in a child with severe hemolytic disease of the fetus and newborn (HDFN), requiring exchange transfusion. Anti-Wra is often identified when Wr(a+) red blood cells (RBCs) are available on the screening or identification panel RBCs, but the antibody is otherwise rarely involved in serious hemolytic

A. Espinosa, L.J. Garvik, N. Trung Nguyen, B. Jacobsen

Immunohematology, Volume 37 , ISSUE 1, 20–24

Article | 16-October-2019

Hemovigilance and the Notify Library

use of MPHO, such as the noncommercial nature of the human body and its parts and strict traceability associated with vigilance and surveillance. The Notify Library1 is the first WHO initiative that covers vigilance across the full MPHO scope. Hemovigilance Hemovigilance of blood transfusions encompasses a set of surveillance procedures that cover the entire collection to transfusion process: from the donor and donation, to the processing of the donor’s blood and its components, to their

B.I. Whitaker, D.M. Strong, M.J. Gandhi, E. Petrisli

Immunohematology, Volume 33 , ISSUE 4, 159–164

Report | 01-December-2019

Transfusion practices for patients with sickle cell disease at major academic medical centers participating in the Atlanta Sickle Cell Consortium

The Atlanta Sickle Cell Consortium represents more than 2600 pediatric and adult patients with sickle cell disease (SCD) in the metropolitan Atlanta, Georgia, area receiving care at four major locations, each providing comprehensive care 24 hours a day, 7 days a week. Both transfusion services that support these sites use two levels of prospective phenotype matching to decrease the rates of alloimmunization. Although exact rates are unknown and are currently under investigation

Anne M. Winkler, Cassandra D. Josephson

Immunohematology, Volume 28 , ISSUE 1, 24–26

Article | 17-February-2021

Clinical impacts of DNA-based typing and provision of antigen-matched red blood cell units for chronically transfused patients with thalassemia

Chronic transfusion in patients with thalassemia is often complicated by red blood cell (RBC) alloantibodies to the lacking antigens on the patients’ RBCs. The prevalence of alloantibodies ranges from 4.25 to 37 percent in patients with thalassemia.1–6 Clinically significant alloantibodies can shorten transfused erythrocyte survival due to hemolytic transfusion reactions. To reduce the alloantibody risk, RBC antigen serotyping for Rh (C, c, E, e) and MNS hybrid glycophorins, especially for MNS7

P. Watanaboonyongcharoen, S. Onspun, P. Rojnuckarin

Immunohematology, Volume 36 , ISSUE 4, 137–145

Report | 16-March-2020

D+ platelet transfusions in D– patients: cause for concern?

prophylactic Rh immunoglobulin (RhIG), results in D alloimmunization. The transfusion records of all patients who received platelet transfusions from December 2004 to March 2007 were reviewed. Transfusion recipients were evaluated with pretransfusion ABO and D typings, and an antibody screen. Recipients were reevaluated in the same manner before subsequent transfusions. Transfusion records of 114 D– patients were analyzed. Overall, 104 patients received D+ platelets; 67 had repeat antibody screening

Angela N. Bartley, John B. Carpenter, Mary P. Berg

Immunohematology, Volume 25 , ISSUE 1, 5–8

Case report | 16-October-2019

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

RHCE*ceEK/ RHCE*ceAR alleles. The patient was previously alloimmunized to D, C, and E and possibly hrS. Further transfusion of D–C–E–K– RBCs resulted in a suspected acute hemolytic transfusion reaction and the subsequent identification of anti-c. Monocyte monolayer assay testing suggests clinical significance with a range of 29.5–38.5 percent reactive monocytes.

Tiffany K. Walters, Thomas Lightfoot

Immunohematology, Volume 34 , ISSUE 3, 109–112

Case report | 01-December-2019

Blood group genotyping in a multitrauma patient: a case report

Currently DNA-based analysis of blood groups is mainly used to improve transfusion safety by reducing alloantibody formation in multiply transfused patients and by monitoring pregnancies at risk for hemolytic disease of the fetus and newborn. We present a case in which genotyping was performed after massive transfusion with unmatched group O, D– blood in a trauma setting. Our patient was genotyped as O1A1 and predicted to be D–, and we therefore transfused group A, D– red

Joyce Curvers, Volkher Scharnhorst, Masja de Haas, Loes Warnier-Wandel, Daan van de Kerkhof

Immunohematology, Volume 28 , ISSUE 3, 85–87

Article | 16-February-2021

PROCEEDINGS FROM THE INTERNATIONAL SOCIETY OF BLOOD TRANSFUSION WORKING PARTY ON IMMUNOHAEMATOLOGY, WORKSHOP ON THE CLINICAL SIGNIFICANCE OF RED BLOOD CELL ALLOANTIBODIES, SEPTEMBER 9, 2016, DUBAI: Clinical significance of antibodies to antigens in the ABO, MNS, P1PK, Rh, Lutheran, Kell, Lewis, Duffy, Kidd, Diego, Yt, and Xg blood group systems

The International Society of Blood Transfusion (ISBT) currently recognizes 36 blood group systems, which contain a total of 322 antigens.1 Table 1 shows the current blood group systems and the number of antigens within each system. The information presented during the Workshop on the Clinical Significance of Red Blood Cell Alloantibodies was collated data from the main review resources available, including Human Blood Groups by Daniels,2 The Blood Group Antigen Factsbook by Reid et al.,3 and

N.M. Thornton, S.P. Grimsley

Immunohematology, Volume 35 , ISSUE 3, 95–101

Case report | 16-March-2020

Autoantibody formation after alloimmunization inducing bystander immune hemolysis

The development of RBC autoantibodies resulting from or associated with allogeneic blood transfusions is not an easily determined complication of RBC transfusions. This report discusses one patient who developed RBC autoantibodies in association with an allogeneic blood transfusion and alloimmunization leading to a temporary bystander immune hemolysis. A 72-year-old woman was hospitalized as a result of severe anemia and received two units of ABO- and D-compatible RBCs. She had a history of two

Mariza Mota, C. Bley, M.G. Aravechia, N. Hamerschlak, A. Sakashita, J.M. Kutner, L. Castilho

Immunohematology, Volume 25 , ISSUE 1, 9–12

Article | 16-November-2020

Platelet transfusion: a review of key concepts

Many clinical situations involve the platelet transfusion support of patients with thrombocytopenia. Among these are patients with leukemia, oncology patients receiving chemotherapy, patients undergoing bone marrow transplantation, patients with idiopathic thrombocytopenia purpura (ITP), and the acute trauma patient. The Transfusion Medicine service plays a key role in the care of patients in that they are expected to provide quality blood products and aid in clinical decision making. Issues

Alan J. Sheinbaum, Jay H. Herman

Immunohematology, Volume 12 , ISSUE 3, 123–126

Article | 17-November-2020

A practice guideline and decision aid for blood transfusion

An attempt was made to reduce exposure of patients to blood products by using a point-of-ordering decision support system and strict adherence to a practice guideline, by observing physician behavior in the multidisciplinary intensive-care unit (ICU) of a tertiary-care medical center. Hemoglobin (Hg) level at the time of transfusion, total units of red blood cells (RBCs) per admission, units per patient per ICU day, fraction of patients receiving no transfusions, and incidence of single-unit

Benjamin Littenberg, Howard Corwin, Andrew Gettinger, Joshua Leihter, James P. AuBuchon

Immunohematology, Volume 11 , ISSUE 3, 88–94

Article | 03-November-2020

Immunoprophylaxis using intravenous Rh immune globulin should be standard practice when selected D-negative patients are transfused with D-positive random donor platelets

A 67-year-old female developed excessive bleeding and thrombocytopenia following cardiovascular surgery. Her blood type was group A, D–. The only platelet products available in the transfusion service were random donor platelet concentrates from D+ donors. She was transfused with a pool of 6 D+ random donor platelet concentrates. Anti-D undetected in her pretransfusion serum by solid-phase antibody screen was present 11 days later. Retrospectively, the patient provided a history of having

Clinton A. Ewing, Dawn H. Rumsey, Albert F. Langeberg, S. Gerald Sandler

Immunohematology, Volume 14 , ISSUE 4, 133–137

Report | 01-December-2019

Red blood cell phenotyping after transfusion: an in vitro model

Recipient red blood cell (RBC) phenotyping using serologic techniques, within 3 months of a transfusion, is considered unreliable. We conducted in vitro experiments to determine how long recipient RBC phenotyping results would be compromised after an allogeneic transfusion. In vitro models were created to mimic in vivo posttransfusion ratios of “transfused” RBCs with either a single or a double dose of an antigen and “autologous” RBCs negative for the corresponding

Kumudini Gonsalkorale, Charlotte Vanhecke, Krishna G. Badami

Immunohematology, Volume 29 , ISSUE 3, 93–96

Case report | 14-October-2020

Case report: four donors with granulocyte-specific or HLA class I antibodies implicated in a case of transfusion-related acute lung injury (TRALI)

. Four of the donors of the implicated units of plasma were female and all had a history of pregnancy. Two donors had HLA class I antibodies and two had granulocytespecific antibodies detectable in their serum. In crossmatch studies, granulocyte-reactive antibodies from two donors bound to granulocytes from the patient, which suggested that these antibodies were clinically relevant. These clinical and serologic findings support a diagnosis of transfusion-related acute lung injury (TRALI).

A. Davoren, O.P. Smith, C.A. Barnes, E. Lawler, R.G. Evans, G.F. Lucas

Immunohematology, Volume 17 , ISSUE 4, 117–121

Review | 03-November-2020

Transfusion-associated bacterial sepsis: a concise review

Stephen J. Wagner, David Lieby

Immunohematology, Volume 14 , ISSUE 1, 33–35

Review | 15-May-2020

Review: transfusion-related acute lung injury: pathophysiology, laboratory investigation,and donor management

Transfusion-related acute lung injury (TRALI) is a serious clinical syndrome that is temporally associated with the transfusion of plasma-containing blood components. The syndrome typically occurs within 6 hours of transfusion. Approximately 80 percent of cases will resolve within 96 hours with supportive care. The syndrome has been associated with antibodies to WBC antigens and generation of biologically active mediators in stored cellular blood components. Appropriate laboratory investigation

Patricia M. Kopko

Immunohematology, Volume 20 , ISSUE 2, 103–111

Article | 10-November-2020

Severe intravascular hemolysis due to autoantibodies stimulated by blood transfusion

Autoantibodies may cause severe hemolytic anemia, but only rarely are they the cause of a hemolytic transfusion reaction due to the destruction of transfused allogeneic blood. In two patients, autoantibody was detected shortly after blood transfusion. The first case was a D-negative patient who produced an autoanti-Ce and subsequently developed hemoglobinuria and hyperbilirubinemia. The second case was a patient who developed an autoanti-Wrb that caused severe hemolysis that resulted in death.

D. Chan, G.D. Poole, M. Binney, M.D. Hamon, J.A. Copplestone, A.G. Prentice

Immunohematology, Volume 12 , ISSUE 2, 80–83

Article | 14-October-2020

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

refractoriness or nonhemolytic reactions;(2) the influence of a history of transfusion on the production of those antibodies; and (3) the effect of screening for those antibodies on the prompt administration of appropriate platelet components. More than half of the platelet transfusion-related problems were associated with platelet-reactive antibodies. For patients with a history of transfusion, the mean period before a clinical problem occurred with platelet transfusions was 9 days,compared with 66 days for

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

Immunohematology, Volume 18 , ISSUE 4, 104–108

Case report | 27-December-2020

Case ABO report: discrepancy due to vancomycin complicating a transfusion reaction investigation

A 3-year-old patient with acute myelogenous leukemia developed fever and chills during transfusion of packed red cells. A preliminary workup suggested that a group AB donor unit had been issued to a Group A patient. However, a discrepancy between the ABO group of the original donor unit segment (A) and blood taken from the IV tubing (AB) and the patient's pre- and posttransfusion samples (A and AB, respectively) suggested another reason for the weak reactivity of some samples with anti-B

Denise M. Gilbert, Ronald E. Domen

Immunohematology, Volume 5 , ISSUE 4, 119–120

Case report | 28-April-2020

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

. Seven months later the patient’s antibody screen remained negative and he was transfused with seven units of D– RBCs and six units of FFP,four of which were D+. Two months later anti-D, -E, and -K were detected in his plasma. Although the anti-E and anti-K could have resulted from transfusion of antigen-positive RBCs, the anti-D could have resulted only from transfusion of the D+ FFP . The D status of FFP is currently not considered when selecting products for transfusion even though the

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

Immunohematology, Volume 21 , ISSUE 4, 149–151

Article | 30-November-2020

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

A patient was transfused with a total of 14 units of red blood cells (RBCs) over 33 days (January 14 to February 15) at two hospitals. Febrile transfusion reactions were noted on three occasions, and hemoglobinuria was seen twice. Alloantibodies were not detected in a sample dated February 14, following a transfusion reaction, and this sample was referred to the North London Blond Transfusion Centre. Further samples were also obtained from before and after all transfusions at both hospitals

Alan Devenish, Lesley A. Kay

Immunohematology, Volume 10 , ISSUE 4, 120–123

Review | 20-March-2020

Historic milestones in the evolution of the crossmatch

The introduction of the serologic crossmatch—first proposed by Hektoen (1907) and first performed by Ottenberg (1908)—made it possible to transfuse blood without fear of unpredictable and potentially disastrous acute hemolytic reactions, most of which were attributable to direct agglutinating (IgM) anti-A, anti-B, or anti-A,B. Previously transfused or previously pregnant recipients continued to experience sporadic hemolytic transfusion reactions as a result of “incomplete

S. Gerald Sandler, Malak M. Abedalthagafi

Immunohematology, Volume 25 , ISSUE 4, 147–151

Article | 10-November-2020

Transfusion-associated circulatory overload in orthopedic surgery patients: a multi-institutional study

Although recognized as a serious complication of hemotherapy, few data are available on the incidence of transfusion-associated circulatory overload (TACO). Detailed demographic and clinical information was obtained from records of 382 Medicare patients undergoing total hip or knee replacements (and receiving transfusions) from January 1992 to December 1993 at five Massachusetts hospitals. Seventy-eight percent of the patients were women with a mean age of 77 years. Thirty-two percent had co

Mark A. Popovsky, Anne-Marie Audet, Chester Andrzejewski, Jr.

Immunohematology, Volume 12 , ISSUE 2, 87–89

Article | 17-February-2021

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

Currently, 343 red blood cell (RBC) antigens are grouped in 43 blood group systems according to the International Society of Blood Transfusion.1 These antigens induce the formation of RBC alloantibodies that are involved in blood incompatibilities, leading to immediate and delayed hemolytic transfusion reactions, and hemolytic disease of the fetus and newborn.2 The definition of rare blood or a rare donor is not yet well established. In most countries, a blood donor or a patient is considered

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

Article | 14-October-2020

Switching donor cells as a major source of error in compatibility testing

The most likely cause of fatality in blood transfusion is transfusion of the wrong unit of blood to a patient. This type of error is usually attributed to improper patient identification at the time of sample collection or transfusion. A retrospective analysis of the results of an external proficiency testing program identified a common source of error occurring during laboratory testing that has not been previously reported. Results were analyzed when major errors were assigned to laboratories

Beverly J. Padget, Judith L. Hannon

Immunohematology, Volume 17 , ISSUE 4, 125–129

Case report | 09-October-2019

Hematologic complications in a patient with Glycine soja polyagglutination following fresh frozen plasma transfusion

Polyagglutination is a rare and underdiagnosed condition, characterized by agglutination of red blood cells (RBCs) with almost all ABO-compatible adult sera. Polyagglutination can occur when a cryptantigen is exposed on RBCs via microbial enzyme activity. Because nearly all adults naturally produce antibodies against cryptantigens, transfusion of plasma can cause unexpected hemolysis and hematologic complications, such as thrombocytopenia and disseminated intravascular coagulation, in patients

Ryan P. Jajosky, Lloyd O. Cook, Elizabeth Manaloor, James F. Shikle, Roni J. Bollag

Immunohematology, Volume 33 , ISSUE 2, 51–55

Case report | 26-October-2019

Transfusion-related acute lung injury in an era of TRALI  risk mitigation

Transfusion-related acute lung injury (TRALI) is a rare complication of transfusion, for which the true incidence remains obscure, since there are a number of factors that may lead to misdiagnosis. Despite this, it continues to be the leading cause of transfusion-associated mortality. Here we present a historical case of TRALI in an elderly female who received group AB plasma and discuss how current mitigation strategies would likely have prevented its occurrence. It is important to remember

John C. Lavelle, Michelle L. Grant, Julie K. Karp

Immunohematology, Volume 31 , ISSUE 4, 155–158

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 | 14-March-2020

The pathophysiology and prevention of transfusion-related acute lung injury (TRALI):  a review

Transfusion-related acute lung injury (TRALI) is a clinically important complication of transfusion that is often difficult to diagnose, is probably underreported, and likely has a multifactorial origin that is incompletely understood, making it challenging to find effective treatments and preventative steps. The spectrum of its severity and clinical symptoms seems wide, but its pathogenesis is most likely associated with pulmonary damage from activated recipient neutrophils. Despite the

David C. Mair, Ted Eastlund

Immunohematology, Volume 26 , ISSUE 4, 161–173

Article | 10-November-2020

Long-term impact of recombinant human erythropoietin on transfusion support in patients with chronic renal failure

Published reports on the impact of recombinant human erythropoi­etin (r-HuEpo) on transfusion requirements of patients with chron­ic renal failure have been limited to small populations and relatively brief follow-up. In this study we reviewed the effects of this drug on 86 patients with well-characterized transfusion requirements, fol­lowed for 18 months at seven dialysis centers. The median red blood cell transfusion requirements per patient per year decreased from 14 in 1987 and

Mark A. Popovsky, Bernard J. Ransil

Immunohematology, Volume 12 , ISSUE 1, 1–3

Article | 18-October-2020

Improving transfusion safety: the bookends of a century

William C. Sherwood

Immunohematology, Volume 16 , ISSUE 1, 22–36

Article | 15-April-2020

Transfusion practices for patients with sickle cell disease at a major academic medical center

The University of North Carolina at Chapel Hill (UNC) is a tertiarycare, academic university hospital and a major referral center for patients across the state of North Carolina. This 700-bed, Level 1 trauma center transfuses more than 22,000 RBC units to patients annually. Clinical services and areas of the hospital which rely most heavily on transfusion support for their activities are transplantation (bone marrow and solid organ), hematology, critical care (medical and surgical intensive

Araba Afenyi-Annan, Nicholas Bandarenko

Immunohematology, Volume 22 , ISSUE 3, 103–107

Review | 09-October-2019

Recognizing and resolving ABO discrepancies

Patient samples are routinely typed for ABO prior to transfusion. Determining the ABO group requires both red blood cell (RBC) antigen typing for A and B (forward type) and testing for anti-A and anti-B in the plasma (reverse type). An ABO discrepancy exists when the result of an ABO RBC typing, or forward type, does not agree with the result of the plasma typing, or reverse type. This brief review examines several causes of ABO discrepancies encountered in the clinical transfusion service

Geralyn M. Meny

Immunohematology, Volume 33 , ISSUE 2, 76–81

Article | 03-November-2020

A comprehensive IgA service provided by a blood transfusion center

IgA is best known in transfusion practice for its deficiency when antiIgA antibodies cause severe anaphylactic reactions. Following the realization that IgA deficient products were needed on demand, blood donors were routinely screened, initially by latex agglutination inhibition and subsequently by hemagglutination inhibition using an Olympus PK-7200™ blood grouping machine. IgA deficiency (<.0016 g/L) was found in 357 (with anti-IgA in 28%) of 301,310 donors, an incidence of 1 in 844

R. Munks, J.R. Booth, R.J. Sokol

Immunohematology, Volume 14 , ISSUE 4, 155–160

Review | 20-March-2020

Recognition and management of antibodies to human platelet antigens in platelet transfusion–refractory patients

Platelet transfusion refractoriness is a problem for parous and multiply transfused patients, placing them at higher risk for morbidity and mortality when posttransfusion count increments are significantly lower than expected. Although nonimmune causes of transfusion refractoriness are very common, HLA alloantibodies are the most important of the less frequent immune factors responsible for inadequate count increments. As universal leukoreduction decreases the occurrence of HLA antibody

Ralph R. Vassallo

Immunohematology, Volume 25 , ISSUE 3, 119–124

Case report | 17-March-2020

Anti-Kpa–induced severe delayed hemolytic transfusion reaction

Kpa is a low-frequency antigen occurring in less than 2 percent of the Caucasian population. Mild to moderate delayed hemolytic transfusion reactions (DHTR) and hemolytic disease of the fetus and newborn attributable to anti-Kpa have been reported. Severe overt DHTR has not been reported with anti-Kpa. A case of a severe DHTR attributed to anti-Kpa after multiple RBC transfusions is being reported. A 52-year-old Caucasian woman received multiple units of RBCs for a lower gastrointestinal bleed

Ranie Koshy, Bhishma Patel, Jonathan S. Harrison

Immunohematology, Volume 25 , ISSUE 2, 44–47

Article | 27-December-2020

Investigation of transfusion reactions through microcomputer education software

The purpose of this study was to develop educational software to simulate laboratory investigation of transfusion reactions. An interactive, branching-style program was developed using a 256K Personal Computer (International Business Machines, Boca Raton, FL). Over 75 institutions in the United States and Canada are currently using the software in preprofessional and continuing professional education programs.

Patrick K. Hardman, Jill T. Hardman, Malcolm L. Beck, Peggy J. Brown, Deborah A. Borek

Immunohematology, Volume 5 , ISSUE 2, 40–44

Review | 16-October-2019

A brief overview of clinical significance of blood group antibodies

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 to provide a brief overview of the clinical significance of blood group antibodies. Blood group antibodies can be naturally occurring (e.g., anti-A and anti-B through exposure to naturally occurring red blood cell [RBC] antigen-like substances) or

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

Immunohematology, Volume 34 , ISSUE 1, 4–6

Case report | 01-December-2019

Hemolytic disease of the fetus and newborn owing to anti-U, successfully treated with repeated intrauterine transfusions

Hemolytic disease of the fetus and newborn (HDFN) owing to anti-U has rarely been reported. U is part of the MNS system. M and N glycoproteins are located on glycophorin A (GPA); S and s antigens are on glycophorin B (GPB). Individuals who lack GPB are S– and s– and also lack U. The U– phenotype occurs almost exclusively in the African population and has a very low frequency (0.25%). Anti-U is of immunoglobulin G class and can cause hemolytic transfusion reaction and HDFN. In

Johanna Strindberg, Joachim Lundahl, Gunilla Ajne

Immunohematology, Volume 29 , ISSUE 2, 51–54

Report | 01-December-2019

Blood group antigen distribution in Lao blood donors

Blood group antigens can be distributed differently within different nationalities. Therefore, information about the prevalence of blood group antigens in the Lao population will be useful for providing better blood transfusion services in the Lao People’s Democratic Republic. The purpose of this study was to determine the prevalence of blood group antigens in Lao blood donors. Blood samples from 464 Lao national volunteer blood donors were typed for antigens in various blood group

Chirapha Keokhamphoui, Yupa Urwijitaroon, Douangchanh Kongphaly, Te Thammavong

Immunohematology, Volume 28 , ISSUE 4, 132–136

Review | 09-October-2019

DEL phenotype

are associated with the RHD*DEL1 or RHD*01EL.01 allele. The prevalence of DEL phenotypes has been reported among D– Han Chinese (30%), Japanese (28%), and Korean (17%) populations. The prevalence of DEL phenotypes is significantly lower among D– Caucasian populations (0.1%). Among the 3–5 percent of African individuals who are D–, there are no reports of the DEL phenotype. Case reports from East Asia indicate that transfusion of DEL RBCs to D– recipients has been

Dong Hyang Kwon, S. Gerald Sandler, Willy Albert Flegel

Immunohematology, Volume 33 , ISSUE 3, 125–132

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

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 | 16-November-2020

Empirical evaluation of the transfusion medicine tutor

Transfusion Medicine Tutor (TMT). The results show that the students who were taught by an instructor using TMT to provide the instructional environment went from 0 percent correct on a pretest case to 87 percent correct on posttests (n = 15). This increase compares with an improvement rate of 20 percent by a control group (n = 15) who used a passive version of the system with the tutoring functions turned off.

Jodi Heintz Obradovich, Philip J. Smith, Stephanie Guerlain, Sally Rudmann, Patricia Strohm, Jack Smith, John Svirbely, Larry Sacks

Immunohematology, Volume 12 , ISSUE 4, 169–174

Article | 09-November-2020

Delayed hemolytic transfusion reaction and paroxysmal cold hemoglobinuria: an unusual association

still weakly positive and the serum contained a weak cold autoagglutinin, which did not correlate with the severity of the hemolysis. A Donath-Landsteiner test was performed and found to be strongly positive. The antibody showed P specificity, confirming a diagnosis of paroxysmal cold hemoglobinuria (PCH). Exchange transfusion was followed by rapid recovery even though the Donath-Landsteiner test remained positive for at least a month. The patient was well when last seen 11 months after presentation

M.A. Wodzinski, R.C. Collin, D.J. Booker, R. Stamps, J.D. Bellamy, R.J. Sokol

Immunohematology, Volume 13 , ISSUE 2, 54–57

Original Paper | 09-October-2019

Use of standard laboratory methods to obviate routine dithiothreitol treatment of blood samples with daratumumab interference

Daratumumab is an antibody currently used in the treatment of patients with refractory multiple myeloma. Blood samples from patients being treated with daratumumab may show panreactivity during pre-transfusion testing. To facilitate the provision of blood components for such patients, it is recommended that a baseline phenotype or genotype be established prior to starting treatment with daratumumab. If patient red blood cells (RBCs) require phenotyping after the start of daratumumab treatment

Nicholas J. Lintel, Debra K. Brown, Diane T. Schafer, Farai M. Tsimba-Chitsva, Scott A. Koepsell, Sara M. Shunkwiler

Immunohematology, Volume 33 , ISSUE 1, 22–26

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

Report | 16-October-2019

Rh and Kell blood group antigen prevalence in a multi-ethnic cohort in Nigeria: implications for local transfusion service

Antigens belonging to the Rh and Kell blood group systems are of major clinical significance because of their immunogenicity and the potential of their consequent antibodies to cause in vivo destruction of exogenous red blood cells (RBCs). Despite the widespread use of transfusion, there are sparse data on the prevalence of Rh and Kell system antigens and their ethnic variability in Nigeria. The objective of this study was to determine the prevalence of the five major Rh (D, C, c, E, e) and

Ademola Samson Adewoyin, Grace Ming Lee, Titilope Adenike Adeyemo, Omolade Augustina Awodu

Immunohematology, Volume 34 , ISSUE 2, 61–65

Article | 10-November-2020

Leukocyte reduction of red cells when transfusing patients with autoimmune hemolytic anemia: a strategy to decrease the incidence of confounding transfusion reactions

transfusing the patient. We report a case of warm autoimmune hemolytic anemia (WAIHA) in which the transfusion of red cells was complicated by a febrile transfusion reaction. Evaluation of the reaction resulted in a significant delay in transfusion therapy. Subsequent administration of leukocyte-poor red cells resulted in uneventful transfusions with a good therapeutic response. Retrospective analysis of the pretransfusion sample demonstrated significant levels of anti-neutrophil antibodies. This case

Jeanne A. Lumadue, Rosetta Sue Shirey, Thomas S. Kickler, Paul M. Ness

Immunohematology, Volume 12 , ISSUE 2, 84–86

Report | 01-December-2019

Transfusion practices for patients with sickle cell disease at the Children's Hospital of Philadelphia

Stella T. Chou, David F. Friedman

Immunohematology, Volume 28 , ISSUE 1, 27–30

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

Case report | 21-March-2020

Hyperhemolytic transfusion reaction attributable to anti-Fy3 in a patient with sickle cell disease

A case of hyperhemolytic transfusion reaction attributable to antiFy3 in a 30-year-oldAfricanAmerican woman with a history of sickle cell disease is reported. The patient was admitted for vaso-occlusive sickle cell crisis and received 4 units of packed RBCs secondary to worsening symptomatic anemia (Hb 5.0 g/dL). On admission,the patient’s antibody screen and identification showed anti-V and antiE,and her antibody history included anti-E,-C,-Jkb,-N,-V,-S,-Sla,and a cold agglutinin with

Meredith A. Reyes, Orieji C. Illoh

Immunohematology, Volume 24 , ISSUE 2, 45–51

Article | 26-October-2019

HEA BeadChipTM technology in immunohematology

by BioArray Solutions (Immucor, Warren, NJ) is one of the commercial DNA array platforms currently available to predict HEAs by DNA analysis. This technology provides a useful tool to increase the inventory of antigen-negative RBC units and prevent immunization of patients who require chronic transfusion by providing compatible RBC units based on matching by DNA testing.

Cinzia Paccapelo, Francesca Truglio, Maria Antonietta Villa, Nicoletta Revelli, Maurizio Marconi

Immunohematology, Volume 31 , ISSUE 2, 81–90

Article | 26-October-2020

Provision of HPA-1a (PlA1)-negative platelets for neonatal alloimmune thrombocytopenia: screening, testing, and transfusion protocol

Mary Munizza, Sandra Nance, Maryann Keashen-Schnell, William Sherwood, Scott Murphy

Immunohematology, Volume 15 , ISSUE 2, 71–74

Article | 16-February-2021

Quality improvement with platelet additive solution for safer out-of-group platelet transfusions

Introduction Transfusion of ABO-incompatible platelet components is an accepted practice in many institutions.1–4 The AABB’s Standards for Blood Banks and Transfusion Services states: “The transfusion service shall have a policy concerning transfusion of components containing significant amounts of incompatible ABO antibodies or unexpected red cell antibodies.”5 This guideline can be implemented in many different ways, leading to a wide variety of hospital practices.6–9 Among 3152 North

M. Tynuv, W.A. Flegel

Immunohematology, Volume 35 , ISSUE 3, 108–115

Article | 30-November-2020

Successful transfusion in the presence of anti-K4 (anti-Kpb)

Type, Bristol, UK, maintained by the World Health Organization. Four units of group O, K:4, E-, S- RBCs were transfudes in the next 24 hours while the K:-4 blood was in transit. No immediate signs of a transfusion reaction were noted. Blood pressure, temperature, bilirubin, and urinary output were normal, and an increase in hemoglobin was observed. A positive direct antiglobulin test was evident 3 days posttransfusion of the incompatible units and was still present 8 days later. Anti-A and anti-K4

Julie M Watt, Peter N. Moffatt, Suzanne Y. Chatfield, Wendy A. Grimm, Jennifer A. Bryant

Immunohematology, Volume 10 , ISSUE 3, 87–89

Review | 28-April-2020

Review: complement receptor 1 therapeutics for prevention of immune hemolysis

The complement system plays a crucial role in fighting infections and is an important link between the innate and adaptive immune responses. However, inappropriate complement activation can cause tissue damage, and it underlies the pathology of many diseases. In the transfusion medicine setting, complement sensitization of RBCs can lead to both intravascular and extravascular destruction. Moreover, complement deficiencies are associated with autoimmune disorders, including autoimmune hemolytic

Karina Yazdanbakhsh

Immunohematology, Volume 21 , ISSUE 3, 109–118

Report | 01-December-2019

Alloimmunization of patients by blood units harboring distinct DEL variants

eight DEL donors. Coincidentally, Canadian Blood Services (CBS) performed a traceback study by investigating the RHD status of donors after a D– recipient developed anti-D after transfusion of two D– red blood cell (RBC) units. Donor genotyping was done either manually (HQ) or using the Progenika Bloodchip platform (CBS). Donations were traced through computer records. Letters were sent to hospital blood bank physicians to verify the presence of anti-D in recipients and to donors to

Maryse St-Louis, André Lebrun, Mindy Goldman, Marianne Lavoie

Immunohematology, Volume 29 , ISSUE 4, 136–140

Article | 09-November-2020

Clinical significance of an anti-Dib assessed by flow cytometry

Although antibodies to the Dib antigen are generally considered to be of potential clinical significance, we know of no reports assessing the clinical significance of anti-Dib (in vivo or in vitro). We report on an 88-year-old Japanese male gastrectomy patient who had alloanti-Dib. After transfusion of two Di(b–) units, three Di(b+) units had to be transfused, and there were no clinical signs of acute hemolysis. Di(b+) RBC survival was followed retrospectively by flow cytometry. On days 1

Regina M. Leger, Patricia A. Arndt, Asuncion Co, Lauren O’Brien, George Garratty

Immunohematology, Volume 13 , ISSUE 3, 93–96

Article | 31-March-2021

Transfusion support during childbirth for a woman with anti-U and the RHD*weak D type 4.0 allele

eliminate the unnecessary administration of RhIG. Case Report and Results A 23-year-old African American woman (gravida 2, para 1) presented for childbirth. The woman had no history of blood transfusion. Testing of her blood sample showed her RBCs to be group B with a serologic weak D phenotype; anti-U was identified by the antibody screening process (Table 1). Without any molecular information for her RHD genotype, the woman was initially considered to be managed as D–. We decided to obtain 3 U– RBC

Q. Yin, K. Srivastava, D.G. Brust, W.A. Flegel

Immunohematology, Volume 37 , ISSUE 1, 1–4

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

Review | 01-December-2019

The LAN blood group system: a review

LAN (Langereis) was officially recognized by the International Society of Blood Transfusion in 2012 as being the 33rd human blood group system. It consists of one single high-prevalence antigen, Lan (LAN1). The ABCB6 protein is the carrier of the Lan blood group antigen. The ABCB6 gene (chromosome 2q36, 19 exons) encodes the ABCB6 polypeptide (ATP-binding cassette protein, subfamily B, member 6), known as a porphyrin transporter. The exceptional Lan– people do not express ABCB6 (Lan null

Thierry Peyrard

Immunohematology, Volume 29 , ISSUE 4, 131–135

Article | 17-February-2021

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

in these studies demonstrated any clinical or serologic evidence of hemolysis.4–7 The safety of this approach was further evaluated in massive transfusion and also in patients with autoantibodies.8–13 The Indian literature has some data in which transfusion safety with the use of TS and IST crossmatch has been compared with AHG crossmatch.14–18 These studies have revealed that the TS approach is safe and cost-effective. Despite knowing the use of AS, it has not been uniformly adopted as a part of

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

Immunohematology, Volume 36 , ISSUE 1, 19–28

Article | 16-February-2021

Workshop on the clinical significance of red blood cell alloantibodies organized by the Working Party on Immunohaematology of the International Society of Blood Transfusion

The clinical significance of red blood cell (RBC) alloantibodies is a matter of high concern for all immunohematologists and transfusion medicine specialists. It is essential to have a clear understanding of this concept when advising clinicians or making clinical decisions regarding the selection of suitable blood for transfusion or in an obstetric setting. Immunohematologists frequently face questions from colleagues and clinicians such as, “Is the alloantibody identified clinically relevant

T. Peyrard

Immunohematology, Volume 35 , ISSUE 3, 105–107

Report | 09-October-2019

Trends of ABO and Rh phenotypes in transfusion-dependent patients in Pakistan

(37.7%), R1r (33.4%), R1R2 (19.4%), R2r (5.2%), and rr (4.3 %). All of the D– patients were rr. In our study, the highest prevalence of ABO phenotypes was group O and the most prevalent Rh antigen was e. Rh phenotyping, along with antibody screening and identification should be performed prior to transfusion of patients requiring multiple transfusions to reduce and possibly prevent the rate of alloimmunization.

Nida Anwar, Munira Borhany, Saqib Ansari, Sana Khurram, Uzma Zaidi, Imran Naseer, Muhammad Nadeem, Tahir Shamsi

Immunohematology, Volume 32 , ISSUE 4, 170–173

Review | 12-March-2020

Granulocyte serology: current concepts and clinical signifcance

Applying serologic procedures to the detection of RBC and lymphocyte antigens has facilitated the identification of granulocyte antigens with established clinical significance, which are now classified in the human neutrophil antigen system. Granulocyte alloantibodies and autoantibodies have been implicated in a variety of clinical conditions including alloimmune neutropenia, autoimmune neutropenia, febrile and severe pulmonary transfusion reactions, drug-induced neutropenia, refractoriness to

Mary E. Clay, Randy M. Schuller, Gary J. Bachowski

Immunohematology, Volume 26 , ISSUE 1, 11–21

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

Case report | 26-October-2019

Anti-Jk3 in a Filipino man

(RBCs) were ordered for transfusion. The patient’s sample typed as group B, D+, and the antibody screen was negative. All six units of packed RBCs appeared compatible (at immediate spin) and were transfused to the patient. His hemoglobin level 4 days post-transfusion was 9.3 g/dL, and the patient was discharged. The patient returned after a week for follow-up and his hemoglobin was found to have dropped to 8.5 g/dL, which continued to fall until it reached 7.0 g/dL. Additional packed RBCs were

Shaina McCaskill, Scott Wise, Sheila Tinsley

Immunohematology, Volume 31 , ISSUE 3, 119–122

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

were identified. The direct antiglobulin test was positive, and the eluate contained anti-c and -Jka. The patient’s hematocrit continued to decrease to 14 percent. Transfusions were withheld and the patient recovered uneventfully. Separate 51Cr red blood cell survival studies showed significantly shortened survival of both autologous and R1R1, Jk(a-), Yt(a+) erythrocytes. This case illustrates the complexity of transfusion management in hemoglobinopathy patients.

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

Immunohematology, Volume 7 , ISSUE 4, 102–106

Article | 14-October-2020

Equivalence of spray-dried K2EDTA,spray-dried K3EDTA, and liquid K3EDTA anticoagulated blood samples for routine blood center or transfusion service testing

from two different manufacturers. All patients’samples were tested in parallel by solid phase/microplate method (Immucor® ABS 2000) and the standard manual tube method. All test results for routine blood bank tests on donors’ and patients’ samples were concordant, demonstrating the equivalence of spray-dried K2EDTA, spray-dried K3EDTA, and liquid K3EDTA blood collection tubes for routine donor center or transfusion service testing.

Stacie Leathem, Nicole Dodge Zantek, Marti Kemper, Laura Korte, Al Langeberg, S. Gerald Sandler

Immunohematology, Volume 19 , ISSUE 4, 117–121

Book Review | 14-October-2020

BOOK REVIEW: Transfusion Reactions

Ruth Mougey

Immunohematology, Volume 18 , ISSUE 4, 124–124

Review | 10-November-2020

A review: transfusion reactions

Cathy Litty

Immunohematology, Volume 12 , ISSUE 2, 72–79

Article | 14-October-2020

Intravenous Rh immune globulin prevents alloimmunization in D– granulocyte recipients but obscures the detection of an alloanti-K

; recipients received multiple D+ granulocyte transfusions from D+ donors and multiple injections of intravenous RhIG at a standard dose of 600 μg for each D+ transfusion. Two D– males with chronic granulomatous disease were given 32 and 13 daily granulocyte transfusions, 18 and 2 of which, respectively, were D+. After the first dose of intravenous RhIG, both patients exhibited circulating anti-D that was undetectable 3 to 4 years later. Two patients with severe aplastic anemia were given 5 and 14

D.F. Stroncek, J.L. Procter, L. Moses, C. Bolan, G.J. Pomper, C. Conry-Cantilens, H.L. Malech, H.G. Klein, S.F. Leitman

Immunohematology, Volume 17 , ISSUE 2, 37–41

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