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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-October-2019

Hemovigilance and the Notify Library

transfusion reactions include acute hemolytic transfusion reactions (AHTRs), delayed hemolytic transfusion reactions (DHTRs), and delayed serologic transfusion reactions (DSTRs) (Table 1).2 Non-hemolytic transfusion reactions are described in Table 2. Table 1. Hemolytic transfusion reaction definitions developed by the Haemovigilance Working Party of the International Society of Blood Transfusion2 Adverse transfusion reaction Definition Hemolytic transfusion reactions (general) A hemolytic

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

Immunohematology, Volume 33 , ISSUE 4, 159–164

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

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

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 | 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 | 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

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

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 | 01-April-2020

Evaluation and management of acute hemolytic transfusion reactions

Lynne Uhl, Susan T. Johnson

Immunohematology, Volume 23 , ISSUE 3, 93–99

Article | 06-December-2020

Reactive lysis - a phenomenon of delayed hemolytic transfusion reactions

Deborah L. Greene, Sanobar Khan

Immunohematology, Volume 9 , ISSUE 3, 74–77

Review | 16-October-2019

A brief overview of clinical significance of blood group antibodies

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

Immunohematology, Volume 34 , ISSUE 1, 4–6

Article | 14-October-2020

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

Beverly J. Padget, Judith L. Hannon

Immunohematology, Volume 17 , ISSUE 4, 125–129

Review | 18-May-2020

Review: IgA anaphylactic transfusion reactions. Part II. Clinical diagnosis and bedside management

S.Gerald Sandler, Nicole Dodge Zantek

Immunohematology, Volume 20 , ISSUE 4, 234–238

Article | 14-December-2020

Primary immune response to blood group antigens in burned children

Delayed hemolytic transfusion reactions (DHTRs) are generally attributed to an anamnestic immune response. Case reports of DHTRs due to a primary immune response are rare. Transfusion reactions occurring in patients on the pediatric burn unit from 1981 to September 1988 were reviewed, and additional information was obtained for patients for whom a DHTR was documented. Of 62 transfusion reactions, 11 were classified as a primary immune response (DHTR), with either a positive antibody screen, a

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

Immunohematology, Volume 7 , ISSUE 1, 8–11

Article | 18-October-2020

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

Mark A. Popovsky, N. Rebecca Haley

Immunohematology, Volume 16 , ISSUE 4, 157–159

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-October-2020

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

antibodies, we chose to implement the gel test to be used with the Tecan MegaFlex-ID. We performed a retrospective analysis of identified antibodies and transfusion reactions to compare the outcomes of one year’s experience with gel and PEG. We found comparable detection of potentially clinically significant antibodies by both methods and significantly fewer unwanted or clinically insignificant antibodies detected with the use of gel. Fewer delayed serologic transfusion reactions and no transfusion

Martha Rae Combs, Steven J. Bredehoeft

Immunohematology, Volume 17 , ISSUE 3, 86–89

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)

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

Immunohematology, Volume 17 , ISSUE 4, 117–121

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 | 15-February-2021

An update on the Lewis blood group system

clinically insignificant and are rarely associated with hemolytic transfusion reactions (HTRs). Three recent reports of Lewis antibodies associated with HTRs have been reported. A case report from 2013 describes a severe HTR due to anti-Lea in a multiply transfused Le(a–b–) patient.9 After receipt of a crossmatch-compatible Le(a+) RBC unit, the patient developed an acute transfusion reaction with fever, chills, severe back pain, hemoglobinuria, and increased levels of bilirubin, alanine transaminase, and

M.R. Combs

Immunohematology, Volume 35 , ISSUE 2, 65–66

Article | 14-October-2020

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

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

Report | 01-December-2019

Implications of the Kidd blood group system in renal transplantation

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

Angela Rourk, Jerry E. Squires

Immunohematology, Volume 28 , ISSUE 3, 91–94

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

Case report | 09-November-2020

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

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

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

Immunohematology, Volume 13 , ISSUE 1, 20–22

Review | 01-December-2019

A review of the JR blood group system

The JR blood group system (ISBT 032) consists of one antigen, Jra, which is of high prevalence in all populations. The rare Jr(a–) phenotype has been found mostly in Japanese and other Asian populations, but also in people of northern European ancestry, in Bedouin Arabs, and in one Mexican. Anti-Jra has caused transfusion reactions and is involved in hemolytic disease of the fetus and newborn. The Jra antigen is located on ABCG2 transporter, a multipass membrane glycoprotein (also known

Lilian Castilho, Marion E. Reid

Immunohematology, Volume 29 , ISSUE 2, 63–68

Article | 16-February-2021

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

, ABO-incompatible platelets may be dispensed. This policy is in line with the practice of many blood banks in the United States.3 Although other institutions have felt compelled to alter their policies regarding ABO-incompatible platelet transfusion after significant AHTRs, our institution felt confident that this case was handled appropriately and made no changes to our policy.12 It is important to continue to educate all staff that hemolytic transfusion reactions are a possible consequence of ABO

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

Immunohematology, Volume 35 , ISSUE 3, 91–94

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

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

Immunohematology, Volume 12 , ISSUE 2, 84–86

Review | 09-October-2019

The H blood group system

) status, and homozygosity or compound heterozygosity for null alleles is associated with the nonsecretor (se) status. H– individuals have natural anti-H (mostly IgM), which can cause severe hemolytic transfusion reactions with intravascular hemolysis.

Erwin Andreas Scharberg, Coral Olsen, Peter Bugert

Immunohematology, Volume 32 , ISSUE 3, 112–118

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

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 | 10-April-2021

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

transfusion reactions (HTRs) or HDFN, other than in isolated case reports.3–12 There is, therefore, a high consensus in the transfusion community regarding the lack of justification for the inclusion of Wr(a+) RBCs on commercial screening and panel RBCs.13–15 The prevalence of Wra has been estimated to be 0.064 percent (1 in 1570) in Norwegian blood donors,16 1 in 1000 in the British population, and 1 in 785 in the Spanish population.17 In a study of Brazilian blood donors,18 the prevalence of Wra was

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

Immunohematology, Volume 37 , ISSUE 1, 20–24

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

Review | 01-December-2019

An update on the GLOB blood group system and collection

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

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

Immunohematology, Volume 29 , ISSUE 1, 19–24

Article | 16-February-2021

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

and Anstee4 showed that RBCs lacking GPA, the major sialoglycoprotein on the RBC surface, lack Ena. This deficiency reduces the overall zeta potential of an intact RBC resulting in RBCs with a higher propensity to agglutinate than RBCs expressing GPA.4 Antibodies against Ena have been associated with hemolytic transfusion reactions and hemolytic disease of the fetus and newborn (HDFN).5 We present a case of the rare Mk phenotype with allo-anti-Ena in a maternal prenatal sample. We discuss the

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

Immunohematology, Volume 35 , ISSUE 4, 159–161

Review | 12-March-2020

The Gerbich blood group system: a review

]). GPC and GPD interact with protein 4.1R, contributing stability to the RBC membrane. Reduced levels of GPC and GPD are associated with hereditary elliptocytosis, and Gerbich antigens act as receptors for the malarial parasite Plasmodium falciparum. Anti-Ge2 and anti-Ge3 have caused hemolytic transfusion reactions, and anti-Ge3 has produced hemolytic disease of the fetus and newborn (HDFN).

Phyllis S. Walker, Marion E. Reid

Immunohematology, Volume 26 , ISSUE 2, 60–65

Article | 14-December-2020

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

. Little data, however, have been published to support this contention. In the present study, the data show a decreased sensitivity for antibody detection when pooled reagent RBCs are used. This reduced sensitivity could result in failure to detect some clinically significant RBC alloantibodies, which might result in the occurrence of overt hemolytic transfusion reactions, especially if an indirect antiglobulin test is not performed at the time blood is crossmatched.

Ira A. Shulman, Roland Nakayama, Cintia Calderon

Immunohematology, Volume 7 , ISSUE 1, 16–19

Report | 06-November-2019

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

, such as which drugs most commonly cause DIIHA, the optimal testing methods for identifying them, and the theories behind the mechanisms by which they react. This article reviews the major changes in DIIHA since the early 1980s involving the immune complex mechanism, cephalosporins, nonimmunologic protein adsorption, and penicillins. Because serologic results associated with DIIHA can mimic those expected with autoimmune hemolytic anemia or hemolytic transfusion reactions, DIIHA may go undetected in

Patricia A. Arndt

Immunohematology, Volume 30 , ISSUE 2, 44–54

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

Report | 16-March-2020

Development and validation of a fluorescent microsphere immunoassay for anti-IgA

Anti-IgA may cause anaphylactic transfusion reactions in IgAdeficient individuals. Testing for IgG anti-IgA is useful to identify persons at risk. This report describes an immunoassay for antiIgA that uses polyclonal IgA coupled to fluorescent microspheres as an immunosorbent. Anti-IgA is detected by phycoerythrin- labeled anti-IgG. The assay is calibrated in arbitrary units by use of a serum that contains anti-IgA. Dose-response studies with sera that contain anti-IgA showed positive responses

Kandelaria M. Rumilla, Jeffrey L. Winters, Jessica M. Peterman, Eric A. Jedynak, Henry A. Homburger

Immunohematology, Volume 25 , ISSUE 1, 24–28

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

Review | 12-March-2020

The Dombrock blood group system: a review

and Dob have a prevalence that makes them useful as genetic markers; however, the paucity of reliable anti-Doa and anti-Dob has prevented this potential from being realized. The ease with which these antigens can be predicted by analysis of DNA opens the door for such studies to be carried out. Anti-Doa and anti-Dob are rarely found as a single specificity, but they have been implicated in causing hemolytic transfusion reactions. This review is a synthesis of our current knowledge of the Dombrock

Christine Lomas-Francis, Marion E. Reid

Immunohematology, Volume 26 , ISSUE 2, 71–78

Article | 14-October-2020

DNA analysis for donor screening of Dombrock blood group antigens

Due to the scarcity of reliable antibodies, RBC typing for Doa and Dob is notoriously difficult. Inaccurate typing can place patients at risk for hemolytic transfusion reactions. The molecular basis of the DOA/DOB polymorphism is associated with three nucleotide changes:378 C>T,624 T>C, and 793 A>G of DO. While the 378 C>T and 624 T>C are silent mutations, the 793A>G polymorphism in codon 265 encodes asparagine for Doa and aspartic acid for Dob . We describe here the use of a

Jill R. Storry, Connie M. Westhoff, Dalisay Charles-Pierre, Maria Rios, Kim Hue-Roye, Sunitha Vege, Sandra Nance, Marion E. Reid

Immunohematology, Volume 19 , ISSUE 3, 73–76

Review | 26-October-2019

Kell and Kx blood group systems

, and alloantibodies to Kell antigens can cause transfusion reactions and hemolytic disease of the fetus and newborn. Kell alloantibodies in pregnancy are known to suppress erythropoiesis, which can result in serious disease despite low amniotic bilirubin levels and low antibody titers. Late-onset anemia with reticulocytopenia is thought to be attributable to the continual suppression of erythropoiesis from residual alloantibody in the infant. Alloimmunization to XK protein is rare, and expressed

Gregory A. Denomme

Immunohematology, Volume 31 , ISSUE 1, 14–19

case-report | 25-June-2021

B subgroup detection in a small hospital transfusion service

patient/donor plasma. Rare hemolytic transfusion reactions (HTRs) due to ABO incompatibility involving ABO subgroups have been reported. As Chun et al.7 reported, a patient with cis-A1B3 interpreted as typical group A experienced adverse effects after transfusion of 4 units of group A RBCs and 4 units of group A fresh frozen plasma (FFP). Although reaction between the B antigen of the cis-AB patient and anti-B from the group A FFP is theoretically possible, the authors could not draw a definitive

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 | 15-April-2020

Serologic and molecular genetic management of a pregnancy complicated by anti-Rh18

Antibodies,such as anti-Rh18 (Hr/HrS),that react with the common products of RHCE can cause HDN as well as severe hemolytic transfusion reactions. Individuals with anti-Rh18 antibodies can have different RHCE genetic backgrounds;therefore,sera and RBCs from these individuals may cross-react. In these situations, genotyping may be the best method to determine compatibility. We report a 26-year-old pregnant Puerto Rican woman who presented at 31 weeks’gestation with anti-E and anti-Rh18 in

Richard L. Haspel, Dawn Michelle, Richard M. Kaufman, Sunitha Vege, Connie M. Westhoff

Immunohematology, Volume 22 , ISSUE 3, 132–135

Article | 20-December-2020

Two cases of autoantibodies that demonstrate mimicking specificity in the Duffy blood group system

Two transfused Caucasian patients presented with possible delayed transfusion reactions. Both patients demonstrated an anti-Fya (Fy1) plus anti-Fyb (Fy2) pattern of reactivity in their sera. The patients’ red blood cells (RBCs) were Fy:1,-2,3. Both had positive direct antiglobulin tests (DAT) with anti-IgG and -C3d. The serum antibodies reacted with the patients’ RBCs drawn when the DATs were negative. Both patients’ serum samples showed reactivity with Fy:1,-2 (1+), Fy:-1,2

Teresa Y. Harris

Immunohematology, Volume 6 , ISSUE 4, 87–91

Case report | 09-October-2019

Hemolytic transfusion reaction attributable to anti-Dia  

(RBCs) in the apheresis unit as part of her regular treatment. When the patient started receiving the implicated unit, she reported back pain, chest pain, and a feeling of anxiety, suggestive of an acute transfusion reaction. The transfusion was ceased and an investigation of an adverse event was commenced. This case illustrates that the presence of antibodies to low-prevalence antigens remains a significant issue for transfusion-dependent individuals. To prevent other transfusion reactions by anti

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

Immunohematology, Volume 33 , ISSUE 1, 6–8

Review | 09-October-2019

The Augustine blood group system, 48 years in the making

phenotype, has only been found in individuals of African origin. Anti-Ata has been implicated in immediate and delayed hemolytic transfusion reactions, but not in severe hemolytic disease of the fetus and newborn. The Augustine gene is SLC29A1, which encodes the equilibrative nucleoside transporter ENT1. At(a–) (AUG:–1,2) results from homozygosity for c.1171G>A, encoding Glu391Lys, whereas the AUGnull (AUG:–1,–2) phenotype results from homozygosity for a splice site mutation

Geoffrey Daniels

Immunohematology, Volume 32 , ISSUE 3, 100–103

Review | 01-December-2019

The LAN blood group system: a review

described as having   variable clinical significance, either for hemolytic transfusion reactions (none to severe) or hemolytic disease of the fetus and newborn (none to mild). Despite challenging conditions caused by the scarcity of Lan– donors worldwide, Lan– blood should ideally be given to patients with anti-Lan, especially those with a high-titer antibody.

Thierry Peyrard

Immunohematology, Volume 29 , ISSUE 4, 131–135

Review | 28-April-2020

Review: complement receptor 1 therapeutics for prevention of immune hemolysis

. In addition, it will be shown in an in vivo mouse model of transfusion reaction that recombinant soluble forms of CR1 can reduce complement-mediated RBC destruction,thereby prolonging survival of transfused RBCs. It is proposed that CR1-based therapeutics have potential for effective and safe prophylactic short-term use and for treatment of hemolytic transfusion reactions.

Karina Yazdanbakhsh

Immunohematology, Volume 21 , ISSUE 3, 109–118

Article | 14-October-2020

Rapid genotyping of the major alleles at the Duffy (FY) blood group locus using real-time fluorescence polymerase chain reaction

The Duffy blood group system has clinical importance due to involvement in transfusion reactions and hemolytic disease of the newborn. Recently, the molecular basis of the two alleles, FY*A and FY*B (125G>A), and the mutation situated in the promoter region of the FY gene (–33T>C), have been elucidated. In order to develop an accurate, easy, and rapid genotyping method, we describe a procedure using the LightCycler®. Samples from 53 Caucasian Portuguese blood donors and 7 black

Fernando M. Araújo, Christina Pereira, Ana Aleixo, Isabel Henriques, Fátima Monteiro, Elsa Meireles, Pedro Lacerda, Luis M. Cunha-Ribeiro

Immunohematology, Volume 17 , ISSUE 2, 42–44

Article | 03-November-2020

A comprehensive IgA service provided by a blood transfusion center

were most commonly referred from departments investigating possible immunodeficiency and suspected transfusion reactions. Of 247 patients investigated, 122 had IgA deficiency, 43 with anti-IgA (of whom 5 had suffered a transfusion reaction). Donors and patients with antiIgA were issued blood group cards warning that they should only receive IgA deficient products.

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

Immunohematology, Volume 14 , ISSUE 4, 155–160

Article | 14-October-2020

Blood group antigen profile predicted by molecular biology - use of real-time polymerase chain reaction to genotype important KEL, JK, RHD, and RHCE alleles

The most clinically important blood group systems in transfusion medicine, excluding the ABO system, are the RH, Kell, and Kidd systems. Alloantibodies to antigens of these systems may be produced following blood transfusion or during pregnancy and can result in serious hemolytic transfusion reactions and hemolytic disease of the newborn.We developed rapid and robust techniques for RHD, RHCE, KEL, and JK genotyping with the use of a real-time polymerase chain reaction instrument. Two

Fernando Manuel Ferreira Araújo, Christiana Pereira, Fátima Monteiro, Isabel Henriques, Elsa Meireles, Pedro Lacerda, Ana Aleixo, Regina Celeste, Luis M. Cunha-Ribeiro, Maria J. Rodrigues

Immunohematology, Volume 18 , ISSUE 3, 59–64

Review | 09-October-2019

The Vel blood group system: a review

. Clinically, anti-Vel is important and has caused severe transfusion reactions, although hemolytic disease of the fetus and newborn caused by anti-Vel is uncommon. However, while screening for Vel– blood donors has become easier, the function of SMIM1 is still unknown, and despite its well-conserved sequence across the animal kingdom, the enigma continues.

Jill R. Storry, Thierry Peyrard

Immunohematology, Volume 33 , ISSUE 2, 56–59

Review | 20-March-2020


phenotype arises from homozygosity for inactivating mutations in the LU gene. The dominantly inherited Lumod phenotype, In(Lu), results from heterozygosity for inactivating mutations in KLF1, the gene for the erythroid transcription binding factor EKLF. Clinically, antibodies of the Lutheran system are relatively benign. When hemolytic, they generally cause only mild, delayed hemolytic transfusion reactions or hemolytic disease of the fetus and newborn that can be treated by phototherapy. The Lutheran

Geoff Daniels

Immunohematology, Volume 25 , ISSUE 4, 152–159

Article | 10-April-2021

Acute hemolytic transfusion reaction caused by anti-Yta

African Americans, with approximately 1 in 2000 Yt(a–) individuals.8 As a result, blood lacking Yta is very rare and should be preserved for its most appropriate use. Anti-Yta is categorized into a group of antibodies with variable clinical significance and unknown hemolytic potential. Therefore, it is of outmost importance to determine those patients who require rare Yt(a–) blood to avoid hemolytic transfusion reactions (HTRs). For this purpose, in vitro methods, such as RBC survival studies or

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

Immunohematology, Volume 37 , ISSUE 1, 13–17

Case report | 27-April-2020

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

rare reports of hemolytic transfusion reactions due to anti-Jra in the literature,most cases,including this one, report that this antibody is clinically insignificant or causes only mild delayed hemolysis. Clinicians should be advised to balance the risks of withholding transfusion with the small chance of significant hemolysis after transfusion of Jr(a+) RBCs in the presence of anti-Jra.

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

Immunohematology, Volume 21 , ISSUE 3, 97–101

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-February-2021

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

in isoagglutinin titers was observed in all platelet components after PAS was applied. Weisberg et al.31 proposed PAS as a method to prevent hemolytic transfusion reactions by minor ABO-mismatched platelet transfusions. We agree, since our data support this recommendation. Even though PAS substantially reduced the number of platelet components exceeding the titer threshold, PAS cannot eliminate all risk, since there is no definitive data to suggest the minimum amount of incompatible plasma that

M. Tynuv, W.A. Flegel

Immunohematology, Volume 35 , ISSUE 3, 108–115

Article | 01-April-2020

Differences in ABO antibody levels among blood donors: a comparison between past and present Japanese,Laotian,and Thai populations

Passively transfused blood group antibodies cause clinical problems. High titers of anti-A and anti-B seem to be one reason for hemolytic transfusion reactions and for ABO HDN. In Japan,anti-A and anti-B titers notably decreased in the 15 years between 1986 and 2001. At present,titers of more than 100,as measured using the saline method,are rare. Differences in the level of anti-A and anti-B among ethnic populations have been reported; these differences were found to be the result of

Toshio Mazda, Kenji Tadokoro, Ryuichi Yabe, Oytip NaThalang, Te Thammavong

Immunohematology, Volume 23 , ISSUE 1, 38–41

Case report | 01-December-2019

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

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

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

Immunohematology, Volume 27 , ISSUE 2, 58–60

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

Case report | 01-December-2019

Anti-Ge2: further evidence for lack of clinical significance

Anti-Ge2 may be immune or naturally occurring, and it reacts with an antigen on glycophorin D. Ge2 is encoded by a gene, GYPC, which is located on the long arm of chromosome 2. Anti-Ge2 is usually an immunoglobulin G (IgG) antibody. In the available literature, we have not been able to find any reported cases of proven acute hemolytic transfusion reactions caused by anti-Ge2. We present the case of a 67-year-old man with metastatic pancreatic carcinoma who had symptomatic anemia and a

Deepthi Karunasiri, Frederick Lowder, Nora Ostrzega, Dennis Goldfinger

Immunohematology, Volume 30 , ISSUE 4, 156–157

Report | 14-March-2020

Absence of hemolytic disease of fetus and newborn despite maternal high-titer IgG anti-Ku

Anti-Ku seen in K0 (Kell-null) individuals has previously been shown to cause severe hemolytic transfusion reactions. Maternal anti-Ku can cause none or moderate to severe hemolytic disease of the fetus and newborn (HDFN). In two of four previously described HDFN cases, intrauterine transfusions were required because of severe anemia. We report a case in which maternal anti-Ku did not cause HDFN. Standard serologic methods were used for RBC antibody screening and identification, adsorption and

Ram M. Kakaiya, Angelica Whaley, Christine Howard-Menk, Jigna Rami, Mona Papari, Sally Campbell-Lee, Zbigniew Malecki

Immunohematology, Volume 26 , ISSUE 3, 119–122

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

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