Red Cell Alloantibodies after Multiple Transfusion in Sharkia.

1Mervat Mostafa Azab, 1Amal M Abd El Moneim, 1Taghrid M Gaafar, 1Naglaa Ali Hussein and 2Mohamed AF Zanaty.

1Clinical Pathology Department and 2Internal Medicine Department, Faculty of Medicine, Zagazig University.

Alloimmunization to foreign red cell antigens is one complication of transfusion that may adversely affect the care of chronically transfused patients. Alloimmunization can cause delay in obtaining compatible blood and can be associated with haemolytic transfusion reaction. This study was planned to evaluate the problem of alloimmunization to red cell antigens in different groups of polytransfused patients. It was conducted on 215 patients: The total percentage of alloimmunization among them was 5.1% divided as follows: 1- One thalassaemic patient had anti-Jka, 2- A case of non lymphoblastic leukaemia who had an allo antibody to a rare antigen and 3- Six cases of end stage chronic renal failure (one with anti-CW, 2 cases with anti-K, a case with anti Kpa, a case with anti-Jsbญญญญ, and a case with anti-E, with a total incidence of 9.5%). No alloantibodies were detected in either schistosomal hepatosplenomegaly or anaemic infant group. In the surgical group (multipara with repeated caesarian sections), the detected antibody was due to pregnancy not due to repeated blood transfusion. As regards the different methods used for detection of alloantibodies, minor discrepancy was detected between conventional methods and manual polybrene test (MPT) and gel test. The study showed a negative correlation between incidence of allo-immunization and the number of transfusions. The severity of the reaction depended on the number of cells involved, the red cell antigens (frequency and potency) and the immunoglobulin class. The anti K was the next most immunogenic antigen after anti-D. Other antibodies as anti JKa,b anti-E, anti-C, anti-Le could frequently be detected. So introduction of blood group systems other than ABO, Rh in routine blood banking specially in multitransfused patients is recommended.