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Irradiation of Red Blood Cells and Alloimmunization.

BACKGROUND: Animal models suggest that red blood cell (RBC) damage incurred during storage can increase immunogenicity to some RBC antigens. We hypothesized that RBC irradiation, a source of oxidative damage, may result in higher RBC alloimmunization rates among transfusion recipients.

METHODS: Individuals receiving 1 or more gamma-irradiated RBC units, with follow-up antibody screening, were studied. We recorded diagnosis at the time of first irradiated RBC-unit transfusion, total irradiated RBCs received, and alloantibodies detected before and after irradiated RBC transfusion.

RESULTS: The alloimmunization rate for patients receiving irradiated RBCs was 1.9% (3/154); this rate was not significantly different from the rate of 2.5% (5/200) derived from a control group that had undergone transfusion with nonirradiated RBCs ( P  > .99). Most of the study subjects (83/154 [53.9%]) did not harbor an immunosuppressive disorder at the time of transfusion of irradiated RBCs, with postoperative bleeding (36/83 [43.4%]) being the most common diagnosis.

CONCLUSIONS: This analysis provides reassurance that irradiated RBCs are not more immunogenic in patients with immunosuppression than in patients with immunocompetence.

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