AI Article Synopsis

  • A study examined the prevalence and risk factors of red blood cell (RBC) immunization in 249 chronic kidney disease (CKD) patients who received blood transfusions at a Malaysian hospital over a year.* -
  • Results showed that 12.4% of patients developed RBC antibodies, with a significant correlation to a history of pregnancy, but no links were found between immunization and factors like demographics or the number of transfusions.* -
  • The findings suggest implementing Rhesus RBC phenotyping for better matching in transfusions, particularly for CKD patients of reproductive age to reduce the risk of RBC immunization.*

Article Abstract

Objectives: Red blood cell (RBC) immunization is a common complication in blood transfusion recipients. Patients with chronic kidney disease (CKD) eventually develop anemia, which is multifactorial, and requires regular blood transfusions, which exposes patients to the development of RBC antibodies. We sought to determine the prevalence and specificity patterns of RBC immunization and its risk factors among transfused CKD patients.

Methods: We conducted a cross-sectional study over one year from January to December 2018 in the Transfusion Medicine Unit, Hospital Universiti Sains Malaysia. A total of 249 samples were recruited from CKD patients who received a blood transfusion (at least one-pint), which only match for ABO and Rh(D) antigen. The serum was screened for the presence of the RBC antibody using the gel agglutination technique (Diamed gel cards). Samples with positive antibody screening were subjected to antibody identification.

Results: Of the 249 transfused CKD patients, 31 (12.4%) developed RBC immunization. Thirty (12%) were alloimmunized, and one (0.4%) was autoimmunized. Anti-Mia was the most common antibody (n = 14, 46.7%) among alloantibodies, followed by anti-E (n = 7, 23.3%). There was a significant association between pregnancy history with the development of antibodies whereas, no significant association was found between sociodemographic background, stage of CKD, hemodialysis status, underlying medical illness, and number of packed cell transfusions with the development of RBC antibodies.

Conclusions: One-eighth of our patient cohort had RBC alloimmunization, and the risk was increased in patients with a history of pregnancy. We propose Rhesus RBC phenotyping and to supply blood match Rhesus antigen in CKD patients, especially patients of reproductive age.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7538639PMC
http://dx.doi.org/10.5001/omj.2020.95DOI Listing

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