Alloimmunization In Patients And Donors Visiting Blood Bank of A Tertiary Care Hospital
Alloimmunization In Patients And Donors Visiting Blood Bank of A Tertiary Care Hospital In North India
Keywords:
alloimmunization, red blood cells, antigen, alloantibodyAbstract
Objective: Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients and is an immune response against foreign RBC antigens; this generally occurs after sensitization due to blood transfusions and pregnancies. We undertook this study to determine prevalence and specificity of RBC alloantibodies in patients and donor attending blood bank of a tertiary care hospital in North India. Method: This was a prospective observational study carried out at Department of Pathology and Blood Bank of Eras Lucknow Medical College and Hospital, Lucknow. Study was carried out for a duration of six months, from July 2016 to December 2016. Proper approval was taken from the institution Ethics Committee. Antibody screening and indentification was carried out in Total 700 cases including 350 Patients and 350 Donors using the ID SYSTEM ( ID – Centrifuge ,37º C Dry Incubator) ID-Dia Cell I-II-III and ID-Dia Panel reagents (Diamed- Biorad, India, Private Limited). ABO and Rh blood groups were done using ID DiaClon ABO/D Grouping cards, containing monoclonal anti-A, anti-B & anti-D suspended in the gel. Results: The incidence of alloimmunization was 0.9% among patients and 0.29% among donors. Among 3 patients detected positive for red cell alloantibody, 2 cases were positive for Anti-D and one was positive for Anti-K alloantibody. The single red cell alloantibody positive donor was positive for Anti-M antibody. [N Gupta, Natl J Integr Res Med, 2018; 9(4):49-54]
References
1. Yazdanbakhsh K, Ware RE, Noizat-Pirenne F. Red
blood cell alloimmunization in sickle cell disease:
pathophysiology, risk factors, and transfusion
management. Blood. 2012;120:528–37.
2. Schonewille H, Haak HL, van Zijl AM.
Alloimmunization after blood transfusion in
patients with hematologic and oncologic diseases.
Transfusion. 1999;39:763–71.
3. Gottvall T, Filbey D. Alloimmunization in
pregnancy during the years 1992–2005 in the
central west region of Sweden. Acta Obstet
Gynecol Scand. 2008;87:843–8.
4. Patel SR, Smith NH, Kapp L, Zimring JC.
Mechanisms of alloimmunization and subsequent
bone marrow transplantation rejection induced by
platelet transfusion in a murine model. Am J
Transplant. 2012;12:1102–12.
5. Al-Joudi F, Ali AB, Ramli MB, Ahmed S, Ismail M.
Prevalence and specificities of red cell
alloantibodies among blood recipients in the
Malaysian state of Kelantan. Asian Journal of
Transfusion Science. 2011;5(1):42-45.
6. Siegel DL. The human immune response to red
blood cell antigens a revealed by repertoire
cloning. Immunol Res. 1998;17:3239–51.
7. Poole J, Daniels G. Blood Group Antibodies and
Their Significance in Transfusion Medicine.
Transfus Med Rev. 2007;21:58–71.
8. Lee CK, Ma ES, Tang M, Lam CC, Lin CK, Chan LC.
Prevalence and specificity of clinically significant
red cell alloantibodies in Chinese women during
pregnancy- a review of cases from 1997 to 2001.
Transfus Med. 2003;13:227–31.
9. Wong KF, Tse KT, Lee AW, Mak CS, So CC. Is
antenatal antibody screening worthwhile in
Chinese. Brit J Haematol. 1997;97:917–9.
10. Spanos T, Karageorga M, Ladis V, Peristeri J,
Hatziliami A, Kattamis C. Red cell alloantibodies in
patients with thalassemia. Vox Sanguinis.
1990;58:50–5.
11. Stahl D, Lacroix-Desmazes S, Sibrowski W,
Kazatchkine MD, Kaveri SV. Red blood cell
ransfusions are associated with alterations in
selfreactive antibody repertoires of plasma IgM
and IgG, independent of the presence of a specific
immune response toward RBC antigens. Clin
Immunol. 2002;105:25–35.
12. Heddle NM, Soutar RL, O’Hoski PL, Singer J,
McBride JA, Ali MA, et al. A prospective study to
determine the frequency and clinical significance
of alloimmunisation post transfusion. Br J
Haematol. 1995;91:1000-05.
13. Hoeltge GA, Domen RE, Rybicki LA, Schaffer PA.
Multiple red cell transfusions and
alloimmunisation. Experience with 6996
antibodies detected in a total of 159,262 patients
from 1985 to 1993. Arch Pathol Lab Med.
1995;119:42-45.
14. Seyfried H, Walewska I. Analysis of immune
response to red blood cell antigens in
multitransfused patients with different diseases.
Materia Medica Polona. 1990;22:21- 25.
15. Schonewille H, Van De Watering LMG, Brand A.
Additional red blood cell alloantibodies after
blood transfusions in a nonhematologic
alloimmunized patient cohort: is it time to take
precautionary measures? Transfusion 2006; 46(4):
630–635
16. Zaman S, Chaurasia R, Chatterjee K, Thapliyal RM.
Prevalence and Specificity of RBC Alloantibodies in
Indian Patients Attending a Tertiary Care Hospital.
Advances in Hematology. 2014;2014:749218.
17. Ameen R, Al-Eyaadi O, Al-Shemmari S, Chowdhury
R, Al-Bashir A. Frequency of red cell alloantibody
in Kuwaiti population. Med Princ Pract.
2005;14:230-34.
18. Xu P, Li Y, Yu H. Prevalence, specificity and risk of
red blood cell alloantibodies among hospitalised
Hubei Han Chinese patients. Blood Transfusion.
2014;12(1):56-60.
19. Promwong C, Siammai S, Hassarin S, et al.
Frequencies and specificities of red cell
alloantibodies in the Southern Thai population.
Asian Journal of Transfusion Science.
2013;7(1):16-20.
20. Reyhanah K, Ahmad G, Gharib K, Vida V, Raheleh
K, Mehdi TN. Frequency & specificity of RBC
alloantibodies in patients due for surgery in Iran.
Indian J Med Res 2013; 138: 252-25
21. Tiwari AK, Pandey P, Sharma J, Shailja K, Dixit S,
Raina V. Incidence of clinically significant
antibodies in patients and healthy blood donors: A
prospective cross-sectional study from a tertiary
healthcare center in India. Transf Apheres Sci.
2014;50:230-34.6.
22. Makroo RN, Bhatia A, Hegde V, Chowdhry M,
Thakur UK, NL Rosamma. Antibody screening &
identification in the general patient population ata tertiary care hospital in New Delhi, India. Indian J
Med Res 2014; 140: 401-405.
23. Kaur D, Bains L, Kandwal M, Parmar I. Erythrocyte
Alloimmunization and Autoimmunization among
Blood Donors and Recipients visiting a Tertiary
Care Hospital. J. Cln. Diagn. Res. 2017; 11(3):
EC12-EC15.
24. Suresh B, Sreedhar Babu KV, Arun R, Jothibai DS,
Bharathi T. Prevalence of “unexpected antibodiesâ€
in the antenatal women attending the
Government Maternity Hospital, Tirupati. J Clin Sci
Res 2015;4:22-30.
25. Karim F, Moiz B, Kamran N. Risk of maternal
alloimmunization in Southern Pakistan - a study in
a cohort of 1000 pregnant women. Transfus Apher
Sci. 2015 Feb;52 (1) :99-102.
26. Hassan MN, Mohd Noor NH, Johan Noor SR, Sukri
SA, Mustafa R, Luc Aster HVR. Hemolytic disease
of fetus and newborn due to maternal red blood
cell alloantibodies in the Malay population. Asian
Journal of Transfusion Science. 2014;8 (2) :113-
117.
27. Varghese J, Chacko MP, Rajaiah M, Daniel D. Red
cell alloimmunization among antenatal women
attending a tertiary care hospital in south India.
The Indian Journal of Medical Research. 2013;138
(1) :68-71.
28. Natukunda B1, Mugyenyi G, Brand A, Schonewille
H. Maternal red blood cell alloimmunisation in.
29. Pahuja S, Gupta SK, Pujani M, Jain M. The
prevalence of irregular erythrocyte antibodies
among antenatal women in Delhi. Blood
Transfusion. 2011;9(4):388-393.
30. Mbalibulha Y, Muwanguzi E, Mugyenyi GR,
Natukunda B. Occurrence of anti-D alloantibodies
among pregnant women in Kasese District,
Western Uganda. Journal of Blood Medicine 2015;
6: 125-129.
31. Suria AA, Nurdiyana MN, Huik May L, Alex YCS,
Noornabillah R, Hud MA, et al. Red Cell Antibody
Screening in Pregnancy: A Preliminary Insight?
Med & Health 2012; 7(1): 41-46.
32. Foudoulaki-Paparizos L, Valsami S, Bournas N,
Tsantes A, Grapsas P, Mantzios G, Travlou A,
Politou M. Alloimmunisation during pregnancy in
Greece: need for nationwide HDFN prevention
programme. Transfus Med. 2013 Aug;23(4) :254-9.
33. Pahuja S, Pujani M, Gupta SK, Chandra J, Jain M.
Alloimmunization and red cell autoimmunization
in multitransfused thalassemics of Indian origin.
Hematology. 2010;15:174–7.
34. Caamaño J, Musante E, Contreras M, Ulloa H,
Reyes C, Veronica I, Saavedra N, Guzman N.
Frequency and Specificity of Red Blood Cell
Alloimmunization in Chilean Transfused Patients.
Transfus Med Hemother. 2015 January; 42(1): 4–
7.
35. Pimpaldara RP, Patel AC, Patel J, Patel S, Pandya
AN, Wadhwani S. A Study of Irregular Antibodies
in 200 Multi-Transfused Patients. Journal of
Evolution of Medical and Dental Sciences 2015;
4(73): 12659-12667
blood cell alloimmunization in sickle cell disease:
pathophysiology, risk factors, and transfusion
management. Blood. 2012;120:528–37.
2. Schonewille H, Haak HL, van Zijl AM.
Alloimmunization after blood transfusion in
patients with hematologic and oncologic diseases.
Transfusion. 1999;39:763–71.
3. Gottvall T, Filbey D. Alloimmunization in
pregnancy during the years 1992–2005 in the
central west region of Sweden. Acta Obstet
Gynecol Scand. 2008;87:843–8.
4. Patel SR, Smith NH, Kapp L, Zimring JC.
Mechanisms of alloimmunization and subsequent
bone marrow transplantation rejection induced by
platelet transfusion in a murine model. Am J
Transplant. 2012;12:1102–12.
5. Al-Joudi F, Ali AB, Ramli MB, Ahmed S, Ismail M.
Prevalence and specificities of red cell
alloantibodies among blood recipients in the
Malaysian state of Kelantan. Asian Journal of
Transfusion Science. 2011;5(1):42-45.
6. Siegel DL. The human immune response to red
blood cell antigens a revealed by repertoire
cloning. Immunol Res. 1998;17:3239–51.
7. Poole J, Daniels G. Blood Group Antibodies and
Their Significance in Transfusion Medicine.
Transfus Med Rev. 2007;21:58–71.
8. Lee CK, Ma ES, Tang M, Lam CC, Lin CK, Chan LC.
Prevalence and specificity of clinically significant
red cell alloantibodies in Chinese women during
pregnancy- a review of cases from 1997 to 2001.
Transfus Med. 2003;13:227–31.
9. Wong KF, Tse KT, Lee AW, Mak CS, So CC. Is
antenatal antibody screening worthwhile in
Chinese. Brit J Haematol. 1997;97:917–9.
10. Spanos T, Karageorga M, Ladis V, Peristeri J,
Hatziliami A, Kattamis C. Red cell alloantibodies in
patients with thalassemia. Vox Sanguinis.
1990;58:50–5.
11. Stahl D, Lacroix-Desmazes S, Sibrowski W,
Kazatchkine MD, Kaveri SV. Red blood cell
ransfusions are associated with alterations in
selfreactive antibody repertoires of plasma IgM
and IgG, independent of the presence of a specific
immune response toward RBC antigens. Clin
Immunol. 2002;105:25–35.
12. Heddle NM, Soutar RL, O’Hoski PL, Singer J,
McBride JA, Ali MA, et al. A prospective study to
determine the frequency and clinical significance
of alloimmunisation post transfusion. Br J
Haematol. 1995;91:1000-05.
13. Hoeltge GA, Domen RE, Rybicki LA, Schaffer PA.
Multiple red cell transfusions and
alloimmunisation. Experience with 6996
antibodies detected in a total of 159,262 patients
from 1985 to 1993. Arch Pathol Lab Med.
1995;119:42-45.
14. Seyfried H, Walewska I. Analysis of immune
response to red blood cell antigens in
multitransfused patients with different diseases.
Materia Medica Polona. 1990;22:21- 25.
15. Schonewille H, Van De Watering LMG, Brand A.
Additional red blood cell alloantibodies after
blood transfusions in a nonhematologic
alloimmunized patient cohort: is it time to take
precautionary measures? Transfusion 2006; 46(4):
630–635
16. Zaman S, Chaurasia R, Chatterjee K, Thapliyal RM.
Prevalence and Specificity of RBC Alloantibodies in
Indian Patients Attending a Tertiary Care Hospital.
Advances in Hematology. 2014;2014:749218.
17. Ameen R, Al-Eyaadi O, Al-Shemmari S, Chowdhury
R, Al-Bashir A. Frequency of red cell alloantibody
in Kuwaiti population. Med Princ Pract.
2005;14:230-34.
18. Xu P, Li Y, Yu H. Prevalence, specificity and risk of
red blood cell alloantibodies among hospitalised
Hubei Han Chinese patients. Blood Transfusion.
2014;12(1):56-60.
19. Promwong C, Siammai S, Hassarin S, et al.
Frequencies and specificities of red cell
alloantibodies in the Southern Thai population.
Asian Journal of Transfusion Science.
2013;7(1):16-20.
20. Reyhanah K, Ahmad G, Gharib K, Vida V, Raheleh
K, Mehdi TN. Frequency & specificity of RBC
alloantibodies in patients due for surgery in Iran.
Indian J Med Res 2013; 138: 252-25
21. Tiwari AK, Pandey P, Sharma J, Shailja K, Dixit S,
Raina V. Incidence of clinically significant
antibodies in patients and healthy blood donors: A
prospective cross-sectional study from a tertiary
healthcare center in India. Transf Apheres Sci.
2014;50:230-34.6.
22. Makroo RN, Bhatia A, Hegde V, Chowdhry M,
Thakur UK, NL Rosamma. Antibody screening &
identification in the general patient population ata tertiary care hospital in New Delhi, India. Indian J
Med Res 2014; 140: 401-405.
23. Kaur D, Bains L, Kandwal M, Parmar I. Erythrocyte
Alloimmunization and Autoimmunization among
Blood Donors and Recipients visiting a Tertiary
Care Hospital. J. Cln. Diagn. Res. 2017; 11(3):
EC12-EC15.
24. Suresh B, Sreedhar Babu KV, Arun R, Jothibai DS,
Bharathi T. Prevalence of “unexpected antibodiesâ€
in the antenatal women attending the
Government Maternity Hospital, Tirupati. J Clin Sci
Res 2015;4:22-30.
25. Karim F, Moiz B, Kamran N. Risk of maternal
alloimmunization in Southern Pakistan - a study in
a cohort of 1000 pregnant women. Transfus Apher
Sci. 2015 Feb;52 (1) :99-102.
26. Hassan MN, Mohd Noor NH, Johan Noor SR, Sukri
SA, Mustafa R, Luc Aster HVR. Hemolytic disease
of fetus and newborn due to maternal red blood
cell alloantibodies in the Malay population. Asian
Journal of Transfusion Science. 2014;8 (2) :113-
117.
27. Varghese J, Chacko MP, Rajaiah M, Daniel D. Red
cell alloimmunization among antenatal women
attending a tertiary care hospital in south India.
The Indian Journal of Medical Research. 2013;138
(1) :68-71.
28. Natukunda B1, Mugyenyi G, Brand A, Schonewille
H. Maternal red blood cell alloimmunisation in.
29. Pahuja S, Gupta SK, Pujani M, Jain M. The
prevalence of irregular erythrocyte antibodies
among antenatal women in Delhi. Blood
Transfusion. 2011;9(4):388-393.
30. Mbalibulha Y, Muwanguzi E, Mugyenyi GR,
Natukunda B. Occurrence of anti-D alloantibodies
among pregnant women in Kasese District,
Western Uganda. Journal of Blood Medicine 2015;
6: 125-129.
31. Suria AA, Nurdiyana MN, Huik May L, Alex YCS,
Noornabillah R, Hud MA, et al. Red Cell Antibody
Screening in Pregnancy: A Preliminary Insight?
Med & Health 2012; 7(1): 41-46.
32. Foudoulaki-Paparizos L, Valsami S, Bournas N,
Tsantes A, Grapsas P, Mantzios G, Travlou A,
Politou M. Alloimmunisation during pregnancy in
Greece: need for nationwide HDFN prevention
programme. Transfus Med. 2013 Aug;23(4) :254-9.
33. Pahuja S, Pujani M, Gupta SK, Chandra J, Jain M.
Alloimmunization and red cell autoimmunization
in multitransfused thalassemics of Indian origin.
Hematology. 2010;15:174–7.
34. Caamaño J, Musante E, Contreras M, Ulloa H,
Reyes C, Veronica I, Saavedra N, Guzman N.
Frequency and Specificity of Red Blood Cell
Alloimmunization in Chilean Transfused Patients.
Transfus Med Hemother. 2015 January; 42(1): 4–
7.
35. Pimpaldara RP, Patel AC, Patel J, Patel S, Pandya
AN, Wadhwani S. A Study of Irregular Antibodies
in 200 Multi-Transfused Patients. Journal of
Evolution of Medical and Dental Sciences 2015;
4(73): 12659-12667
Downloads
Published
2018-08-31
How to Cite
Gupta, N., Riaz Mehdi, S., Zaidi, N., & Ahmad, S. (2018). Alloimmunization In Patients And Donors Visiting Blood Bank of A Tertiary Care Hospital: Alloimmunization In Patients And Donors Visiting Blood Bank of A Tertiary Care Hospital In North India. National Journal of Integrated Research in Medicine, 9(4), 49–54. Retrieved from http://nicpd.ac.in/ojs-/index.php/njirm/article/view/2382
Issue
Section
Original Articles
