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Jennifer Ricci Hagman, Julia S Westman, Åsa Hellberg, Martin L Olsson
The main change that has occurred in the GLOB blood group system since the GLOB review published in this journal in 2013 is the addition of an antigen. The high-prevalence PX2 antigen, originally recognized as the x2 glycosphingolipid, is expressed on red blood cells of most individuals and is elevated in the rare PP1Pk-negative p blood group phenotype. P synthase, encoded by B3GALNT1, was found to elongate paragloboside to PX2 by adding the terminal β3GalNAc moiety. Hence, PX2 was moved from the GLOB collection to the GLOB system...
December 2018: Immunohematology
Ernest M Ekema
Cold-reactive autoantibodies can mask the presence of underlying clinically significant alloantibodies in a patient's plasma or serum. These autoantibodies are problematic when performing laboratory procedures such as ABO typing, red blood cell (RBC) crossmatching, antibody detection testing, and antibody identification. To avert the masking of clinically significant alloantibodies in a patient's plasma or serum, adsorption studies can be performed at 4°C using autologous RBCs if the patient has not been recently transfused...
December 2018: Immunohematology
Letícia Tavares, Daiane Cobianchi Da Costa, Anna Paula de Borba Batschauer, Luiz Fernando Job Jobim, Gisele Menezes Ewald, Carolina de Mello, Eduardo Samuel Alvarez Velazquez, Alexandre Geraldo
Chimerism is a phenomenon in which an individual has cells with different genetic content from different zygotes. In dizygotic twins (DTs), chimerism is believed to occur through placental anastomoses that enable the bidirectional exchange of hematopoietic stem cells. Little is still known about chimerism frequency in twins, but several studies have shown a relation between chimerism and some conditions such as autism, Alzheimer's disease, and a group of autoimmune diseases such as Sjögren syndrome, systemic lupus erythematosus, and systemic sclerosis...
December 2018: Immunohematology
Stephanie Dupuis
The prewarm (PW) method is useful for detecting and identifying clinically significant antibodies that bind to red blood cells and complement at 37°C and for avoiding antibodies that bind at temperatures less than 37°C. Antibodies that bind at temperatures less than 37°C are often cold autoantibodies that may be present in the serum of healthy individuals and are usually not clinically significant. The PW method is useful when these cold autoantibodies have a wide thermal range and interfere with standard testing methods by reacting at the 37°C and antihuman globulin test phases...
December 2018: Immunohematology
Ugo Salvadori, Roberto Melotti, Daniela L'Altrella, Massimo Daves, Ahmad Al-Khaffaf, Laura Milizia, Rossana Putzulu, Renata Filippi, Aurelio Carolo, Giuseppe Lippi, Ivo Gentilini
The increase of immunization against blood group antigens has reinforced the need for automated extensive blood typing. The aim of this study was to assess both the validity and reliability of red blood cell (RBC) automated agglutination technology in testing for antigens of Kidd (Jk), Duffy (Fy), and MNS (Ss) blood systems. ORTHO Sera (Ortho Clinical Diagnostics, Raritan, NJ) anti-Jka, anti-Jkb, Anti-Fya, anti-Fyb, anti-S, and anti-s reagents were each tested on RBC samples previously typed. Replicates were performed on three separate testing sessions with three consecutive repetitions within each session, thus obtaining 486 test results...
December 2018: Immunohematology
Lorraine N Blagg
Dithiothreitol (DTT) and 2-mercaptoethanol (2-ME) are sulfhydryl compounds that can be used to treat serum or plasma to denature IgM antibody reactivity. By using sulfhydryl agents, IgG and IgM antibodies can be separated, the relative amount of IgM and IgG antibodies can be determined, and the risk of hemolytic disease of the fetus and newborn can be assessed.
December 2018: Immunohematology
Cami Melland, Connie Hintz
Polyagglutination is a condition in which red blood cells (RBCs) are agglutinated by normal adult human sera but not by autologous or newborn sera. Polyagglutination is caused by changes in the RBC membrane that enable patient RBCs to agglutinate with normal human sera; this agglutination can interfere with blood bank testing. Depending on the cause, polyagglutination may or may not be the cause of RBC hemolysis. Lectins and human sera can be used to detect polyagglutinable RBCs. Identification of this phenomenon can be helpful in providing not only transfusion recommendation information for physicians but also information associated with pathogens (i...
September 2018: Immunohematology
Tiffany K Walters, Thomas Lightfoot
The Rh system is the most complex of the human blood groups. Of the 55 antigens that have been characterized, the system's principal antigens D, C, E, c, and e are responsible for the majority of clinically significant Rh antibodies. In the last few years, advancements in molecular testing have provided a wealth of information on the genetic diversity of the Rh locus. This case report describes a patient with variant RHD*DAR alleles inherited in conjunction with two compound heterozygote RHCE*ceEK/RHCE*ceAR alleles...
September 2018: Immunohematology
Sofia L Crottet
This article reviews information regarding the clinical significance of antibodies to antigens in the Scianna, Dombrock, Colton, Landsteiner-Wiener, Chido/Rodgers, H, Kx, Cromer, Gerbich, Knops, Indian, and Ok blood group systems. Like most blood group systems, antibodies to many of the antigens in these groups are rarely encountered because of the high prevalence of the associated antigens in most populations. For many, the clinical significance-that is, the potential to cause reduced survival of transfused antigen-positive red blood cells or a transfusion reaction (e...
September 2018: Immunohematology
Thandar Aye, Patricia A Arndt
Chloroquine diphosphate (CDP) is a helpful tool in the blood bank for two main applications. The most common application is to render direct antiglobulin test-positive red blood cells (RBCs) free from membrane-bound IgG; these treated RBCs can then be used for autologous adsorption and/or to determine the patient's RBC phenotype. Another common use of CDP is to remove human leukocyte antigens (HLAs) from RBCs to help identify or exclude the presence of antibodies to HLAs expressed on RBCs, for example, Bennett-Goodspeed (Bg) antigens...
September 2018: Immunohematology
Mary E Harach, Joy M Gould, Rosemary P Brown, Tricia Sanders, Jay H Herman
The inherent tradeoff between sensitivity and specificity in the detection of unexplained antibodies has been the objective of many studies, editorials, and journal articles. Many publications note that no method is capable of detecting all clinically significant antibodies while avoiding all clinically insignificant antibodies. This study describes the frequency of nonspecific reactivity and unexplained reactivity in solid-phase testing, along with the subsequent development of specific antibodies (Abs). In this study, nonspecific reactivity (NS) is defined as method-specific panreactivity detected by solid-phase testing only, with no reactivity in other methods...
September 2018: Immunohematology
Kayla L Waider
Rouleaux is a phenomenon that commonly occurs in patients who have an increased number of circulating protein macromolecules. It is a benign, in vitro reaction that appears microscopically as red blood cells (RBCs) line up against each other; many liken the RBC aggregation to "stacked coins." This unexpected reactivity may cause confusion in direct agglutination testing such as reverse blood typing and crossmatching. Saline replacement is the established method to resolve rouleaux. True agglutination will remain when plasma is replaced with saline for resuspension of the RBC button...
September 2018: Immunohematology
Mostafa Moghaddam, Amir A Naghi
This article reviews information on the clinical significance of antibodies to antigens in the Raph, John Milton Hagen, I, Globoside, Gill, Rh-associated glycoprotein, FORS, JR, LAN, Vel, CD59, and Augustine blood group systems. Antibodies to many of the antigens in these groups are rarely encountered because of the high prevalence of the associated antigens in most populations. For many of these antibodies, the clinical significance-that is, the potential to cause reduced survival of transfused antigen-positive red blood cells or a transfusion reaction (e...
September 2018: Immunohematology
Sheetal Malhotra, Gita Negi, Aseem K Tiwari
To the Editors: Alloimmunization is triggered when an individual whose red blood cells (RBCs) are lacking particular antigens is exposed to these antigens through transfusion or pregnancy, causing the formation of immune antibodies. In addition to these exogenous exposures, underlying inflammatory or autoimmune conditions may lead to formation of unexpected antibodies. Individual factors also play a role, since some people are responders and others are non-responders. We report a case of naturally occurring alloanti-N and alloanti-S in a healthy D+ blood donor...
June 2018: Immunohematology
Ademola S Adewoyin, Grace M Lee, Titilope A Adeyemo, Omolade A Awodu
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 wide-spread 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 Kell (K) system antigens in Nigeria with the goal of understanding alloimmunization risk in transfusion recipients and improving transfusion safety through the availability of resources, such as antisera for extended RBC typing and antigen panels for alloantibody detection...
June 2018: Immunohematology
LeeAnn Walker
The use of low-ionic-strength saline (LISS) solution as an enhancement for antibody screening and crossmatching was first described by Löw and Messeter in 1974. This method allowed for a reduced incubation time while maintaining adequate specificity and sensitivity of the antiglobulin test (AGT). Since then, the LISS-AGT tube method has been widely used in antibody detection and identification, as well as compatibility testing. As initially described, the method used red blood cells suspended in LISS. Modifications of the method led to development of the commercially prepared LISS additive solutions in use today...
June 2018: Immunohematology
Nampeung Anukul, Nipapan Leetrakool, Praijit Tanan, Poonsub Palacajornsuk, Phennapha Klangsinsirikul
Mixed-field agglutination (MFA) can be observed in forward typing of samples from A3 individuals with serologic ABO typing methods. The results of column agglutination testing (CAT) and tube agglutination testing using different antibody clones can be discordant. In this report, we reveal our experience using polymerase chain reaction-sequence-based typing (PCR-SBT) of ABO exon 7 to clarify serologic method discordance of A subgroup blood typing in Northern Thai donors. A total of 21 group A blood donors with either MFA or weak agglutination on routine ABO CAT were recalled...
June 2018: Immunohematology
Adam Cobaugh
Cold-reactive autoagglutinins may mask the presence of underlying clinically significant alloantibodies. Adsorption with rabbit red blood cells (RBCs) or stroma can remove cold autoagglutinins found in the patient's plasma/serum that are directed towards antigens expressed on the surface of rabbit RBCs. By removing these cold autoagglutinins, it is then possible to determine whether any underlying alloantibody reactivity is present. Although this method may also unintentionally adsorb alloantibodies directed towards antigens found on rabbit RBCs, it is still a widely used and convenient method to remove cold autoagglutinins...
June 2018: Immunohematology
Christine Lomas-Francis
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 reaction (e.g., anti-AnWj, anti-Emm), or hemolytic disease of the fetus and newborn (e...
June 2018: Immunohematology
Laura L W Cooling, Michelle Herrst, Sherri L Hugan
ABO-incompatible (ABOi) hematopoietic stem cell transplants (HSCTs) can present challenges in the blood bank. During transplantation, patients receive components that are ABO-compatible with both the donor graft and recipient; this practice can strain group O red blood cell (RBC) inventories.1 In addition, there are risks for acute hemolysis at the time of infusion and in the early post-transplant period.1,2 In ABO major-incompatible bone marrow HSCTs, which contain significant quantities of donor RBCs that are ABOi with recipient plasma, it is common to perform a RBC depletion of the bone marrow in an effort to minimize hemolysis at the time of infusion...
January 2018: Immunohematology
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