[Transfusion management of patients with red blood cell antibodies].

INTRODUCTION: Red blood cell antibodies may cause a positive result of pre-transfusion blood compatibility testing (crossmatch test). It can be a problem to provide suitable blood units for patients with clinically significant antibodies to high-frequency antigens as well as for those with multiple alloantibody specificities. This study was aimed at identifying transfused patients in the population of South-Backa who had developed clinically significant red blood cell alloantibodies.

MATERIAL AND METHODS: We analyzed the records of crossmatch results and antibody screening performed at the Blood Transfusion Institute of Vojvodina during 2012.

RESULTS: Antibodies were found in 103 patients: A) 63 patients with single antibodies: 1) 16 with antibodies of unknown specificity (3 autoantibodies, 13 alloantibodies); 2) 39 with clinically significant antibodies (23 from Rh system (2 anti-C, 2 anti-D, 12 anti-E, 7 anti-c), 4 anti-K, 3 anti-Fya, 7 anti-Jka, 2 anti-S); 3) 8 with usually not significant antibodies (6 anti-M, 1 anti-Al, 1 antiC); B) 40 patients developed multiple antibodies: 1) all patients had at least one clinically significant antibody from various blood group system (44 Rh, 13 Kell, 7 Kidd, 7 MNSs (S, s)); 2) 3 patients had usually not significant antibodies (1 Lewis, 2 Lutheran); 3) 3 patients occasionally had clinically significant antibody (3 anti-Ytd4) 3 patients had antibodies of unknown specificity (2 autoantibodies, lalloantibody). Antibodies detected in the majority of patients (65-63.1%) had a specificity of Rh and/or the Kell system.

CONCLUSIONS: The main goal of pre-transfusion blood compatibility testing is to detect clinically significant antibodies. The provision of antigen negative blood units for those patients is a special challenge for blood establishments. Database with a sufficient number of typed blood donors can help to resolve this problem.