Anaphylactic reaction with prothrombin complex concentrate in a patient with IgA deficiency and anti-IgA antibodies.

Immunoglobulin A (IgA) deficiency with anti-IgA antibodies is not listed as an absolute or relative contraindication for the use of prothrombin complex concentrates (PCCs). We discuss a patient who developed an anaphylactic reaction to PCC on a background of selective IgA deficiency with anti-IgA antibodies and with a history of anaphylactic reaction to other blood products. Further analysis of PCCs revealed the presence of variable quantities of immunoglobulins of all classes, including IgA.

ABO incompatible living renal transplantation with a steroid sparing protocol.

Background: ABO incompatible (ABOi) live-donor renal transplantation is a successful and accepted form of treatment for patients with renal failure. Although there is significant controversy as to how antiblood group antibodies should be removed and their resynthesis prevented, subsequent immunosuppressive regimes have all involved steroids. We and other groups have successfully used steroid sparing regimes for conventional ABO compatible transplantation and this study describes the use of our steroid sparing protocol in ABOi transplantation.

Erythroid urea transporter deficiency due to novel JKnull alleles.

Background: The Kidd blood group antigens Jka and Jkb are encoded by the red blood cell (RBC) urea transporter gene. Homozygosity for silent JK alleles results in the rare Jk(a-b-) phenotype. To date, seven JKnull alleles have been identified, and of these, two are more frequent in the Polynesians and Finns.

Will transplantation of kidneys from donors with blood group A2 into recipients with blood group B help British Indo-Asian patients with renal failure?

Despite a high incidence of renal failure, disproportionately fewer Indo-Asians in the United Kingdom receive a renal transplant, in part because of the high prevalence of blood group B. It is now clear that it is possible to safely transplant kidneys from donors with blood group A of the subtype A2 into recipients with blood group B if the latter have low titers of anti-A antibodies. We measured the anti-A titers in 25 Indo-Asian patients on dialysis being considered for transplantation and found stably low titers in all.

RBC T activation and hemolysis in a neonatal intensive care population: implications for transfusion practice.

Background: Reports of transfusion-associated hemolysis in infants with T-activated RBCs have led to the suggestion that infants should be screened and provided with low-titer anti-T blood components. T-activated RBCs react with the lectins Arachis hypogea and Glycine soja; variants of T (Th and Tx) and Tk also react with A. hypogea, but not G.