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Transfusion medicine

Tranfusion reaction

Red blood cell alloimmunization

Reviewer: Huy Phu Pham, M.D. (see Reviewers page)
Revised: 4 November 2011, last major update September 2011
Copyright: (c) 2007-2011, PathologyOutlines.com, Inc.


● Red cell alloantibodies other than naturally occurring anti-A or anti-B are called unexpected red cell alloantibodies
● Only occurs in patients with history of pregnancy, transfusion, transplantation
● Appears to be regulated by CD4+ CD25+ T cells (Am J Hematol 2007;82:691)

● Occurs in 3% of general population, 37% with thalassemia (Transfus Med 2006;16:200), 18-47% with sickle cell anemia (Transfusion 2002;42:37), 20% if prior transfusion but no hematologic or oncologic disease
● Still occurs in pregnancy despite widespread antenatal and postpartum Rhesus immune globulin (RhIG), due to inadvertent failure to administer and antenatal sensitization prior to administration of RhIG (Semin Hematol 2005;42:169)

● Incidence not affected by prestorage leukoreduction (Br J Haematol 2005;129:151)
● Different antibodies appear at different times after transfusions (Transfusion 2006;46:250)
● Usually no acute hemolytic transfusion reactions even if red cell antibodies present, if accurate antibody identification and component phenotyping occurs during compatibility testing
● May cause transfusion challenges in solid organ transplant patients (Transplantation 2007;84:527)
● Recommended to match red cells for E antigens in thalassemia patients (Southeast Asian J Trop Med Public Health 2006;37:1015)
● Alloimmunization may be reduced by molecular testing (Curr Opin Hematol 2006;13:471, Transfusion 2006;46:841)

End of Transfusion Medicine > Tranfusion reaction > Red blood cell alloimmunization

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