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Immunohematology

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https://www.readbyqxmd.com/read/29608324/the-devil-is-in-the-details-retention-of-recipient-group-a-type-5-years-after-a-successful-allogeneic-bone-marrow-transplant-from-a-group-o-donor
#1
Laura L W Cooling, Michelle Herrst, Sherri L Hugan
ABO-incompatible (ABOi) hematopoietic stem cell transplants (HSCTs) can present challenges in the blood bank. During transplantation, patients receive components that are ABO-compatible with both the donor graft and recipient; this practice can strain group O red blood cell (RBC) inventories.1 In addition, there are risks for acute hemolysis at the time of infusion and in the early post-transplant period.1,2 In ABO major-incompatible bone marrow HSCTs, which contain significant quantities of donor RBCs that are ABOi with recipient plasma, it is common to perform a RBC depletion of the bone marrow in an effort to minimize hemolysis at the time of infusion...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29608323/recovery-of-autologous-sickle-cells-by-hypotonic-wash
#2
Emily Wilson, Kelly Kezeor, Monica Crosby
It is important to isolate autologous red blood cells (RBCs) from transfused RBCs in samples from recently transfused patients to ensure that accurate serologic results are obtained. Typically, this isolation can be performed using methods that separate patient reticulocytes from transfused, older donor RBCs. Patients with sickle cell disease (SCD), however, characteristically have RBCs with altered membrane and morphological features, causing their RBCs to take on a sickle-shape appearance different from the biconcave disc-shape appearance of "normal" RBCs...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29608322/a-review-of-in-vitro-methods-to-predict-the-clinical-significance-of-red-blood-cell-alloantibodies
#3
Sandra J Nance
This review was derived from a presentation made on September 2, 2016, for the first Academy Day presented by the Working Party on Immunohematology at the International Society of Blood Transfusion (ISBT) Congress in Dubai. The focus of this review is on the clinical significance of alloimmunization in transfusion-specifically, the parameters that contribute to a clinically significant alloantibody. The areas of focus were as follows: Introduction, Technical Aspects, and Indications and Limitations. Each section contains a brief review of selected literature and experiential knowledge...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29608321/management-of-pregnancy-sensitized-with-anti-inb-with-monocyte-monolayer-assay-and-maternal-blood-donation
#4
Raj Shree, Kimberly K Ma, Lay S Er, Meghan Delaney
Maternal red blood cell (RBC) alloantibodies can cause hemolytic disease of the fetus and newborn (HDFN). Although much is described about common antibodies associated with HDFN, management of a pregnancy complicated by a maternal rare antibody presents several challenges related to assessment of fetal anemia risk, availability of blood for transfusion to the mother and/or the fetus or newborn if needed, and planning for delivery in the case of maternal hemorrhage. Here we report the laboratory medicine workup of a patient who presented for obstetrical care in the United States in the third trimester and had a rare antibody (anti-Inb)...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29608320/a-brief-overview-of-clinical-significance-of-blood-group-antibodies
#5
Manish J Gandhi, D M Strong, Barbee I Whitaker, Evangelia Petrisli
This review was derived from a presentation made on September 2, 2016 for the first Academy Day presented by the Working Party on Immunohematology at the International Society of Blood Transfusion (ISBT) Congress in Dubai. The focus of this review is to provide a brief overview of the clinical significance of blood group antibodies. Blood group antibodies can be naturally occurring (e.g., anti-A and anti-B through exposure to naturally occurring red blood cell [RBC] antigen-like substances) or can occur via exposure to foreign (donor) RBC antigens through previous transfusions, transplants, or exposure to fetal RBCs during or after pregnancy...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29608319/warm-autoadsorption-using-zzap
#6
Farai M Tsimba-Chitsva, Amy Caballero, Becky Svatora
The masking of clinically significant alloantibodies by warm autoantibodies presents challenges in pretransfusion testing. The adoption of transfusion practices such as the issuing of "least incompatible" red blood cells (RBCs) without a complete antibody workup is potentially unsafe for patients. Several autoadsorption methods can be used to remove autoantibody reactivity. ZZAP treatment of autologous RBCs is an efficient way to prepare the cells for autoadsorption. Autoadsorbed serum or plasma can then be used to remove autoantibody reactivity and identify clinically significant alloantibodies...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29378150/dithiothreitol-treatment-of-red-blood-cells
#7
Carolina B Bub
Dithiothreitol (DTT), a reducing reagent, has multiple applications in blood bank testing. DTT disrupts the bridging of the disulfide bonds between amino acid residues necessary for structural conformation of some proteins and the bonds holding an IgM molecule in the pentameric formation. DTT treatment of red blood cells (RBCs) can denature or modify certain blood group antigens-in particular, those in the Kell, Lutheran, YT, JMH, LW, Cromer, Indian, Dombrock, and Knops systems-and prevent recognition by the corresponding antibodies...
December 2017: Immunohematology
https://www.readbyqxmd.com/read/29378149/clinical-and-laboratory-profile-of-anti-m
#8
Debapriya Basu, Sabita Basu, Mahua Reddy, Kaushik Gupta, Mammen Chandy
Anti-M is a frequently detected naturally occurring antibody that has been reported in various clinical settings and also in voluntary donors. We describe here the clinical and laboratory findings of 11 cases with anti-M detected at our center. This report is a retrospective study in which we reviewed our immunohematology laboratory records for cases involving anti-M. Both donor and patient data from a 28-month period (September 2014 to December 2016) were reviewed. During this period, 11 examples of anti-M were detected (8 patients, 1 voluntary whole blood donor, and 1 hematopoietic stem cell donor...
December 2017: Immunohematology
https://www.readbyqxmd.com/read/29378148/hemovigilance-and-the-notify-library
#9
Barbee I Whitaker, D M Strong, Manish J Gandhi, Evangelia Petrisli
Hemovigilance systems allow reporting of adverse occurrences associated with blood transfusion to a central database where events can be reviewed and analyzed for the benefit of patients and donors. Hemolytic and serologic transfusion reactions are among the many types of reactions reported to these systems. The Notify Library, a database of adverse events associated with medical products of human origin, has incorporated hemovigilance into its didactic resources. Students and practitioners are encouraged to use the electronic library and to further enhance this resource through review and recommendation of additional publications in the area of immunohematology...
December 2017: Immunohematology
https://www.readbyqxmd.com/read/29378147/separation-of-multiple-antibodies-by-adsorption-with-allogeneic-red-blood-cells
#10
Ernest M Ekema
Antibody detection and identification are processes that are commonly performed in the transfusion service before transfusion of allogeneic red blood cells (RBCs). Antibody identification usually follows the discovery of a positive antibody detection test, or other factors such as ABO serum/cell discrepancy or an incompatible crossmatch. Antibody identification is a necessary practice in blood banking to determine the suitability of blood products for transfusion on an individual basis. When the presence of multiple antibodies is suspected, several methods, including neutralization of patient's plasma, titration, elution, chemical or enzyme treatment of reagent RBCs, and adsorption with allogeneic RBCs, may be used to separate and properly identify other atypical antibodies that are present in a single serum or plasma sample...
December 2017: Immunohematology
https://www.readbyqxmd.com/read/29378146/anti-vel-alloimmunization-and-severe-hemolytic-disease-of-the-fetus-and-newborn
#11
Kenneth J Moise, Yisel Morales, Marsha F Bertholf, Susan N Rossmann, Yu Bai
Only rare cases of anti-Vel-associated mild-to-moderate hemolytic disease of the fetus and newborn have been previously reported. No case of fetal anemia requiring prenatal therapy has been noted to date. We report such a case recently encountered at our Fetal Center. Strategies are discussed for managing pregnancy complicated with alloimmunization to an antibody to a high-prevalence antigen, including sources of red blood cells for intrauterine transfusions.
December 2017: Immunohematology
https://www.readbyqxmd.com/read/29378145/assessment-of-common-red-blood-cell-pretreatments-to-yield-an-accurate-serologic-antigen-phenotype-compared-with-genotypepredicted-phenotype
#12
Trina Horn, Janis Hamilton, Joanne Kosanke, Virginia W Hare, Wendy Kluver, Wendy Beres, Sandra Nance, Margaret A Keller
For patients requiring multiple transfusions and patients with positive direct antiglobulin tests (DATs), an extended red blood cell (RBC) phenotype can provide valuable information and help to determine the risk of forming alloantibodies. In some instances, the phenotype may be used for prophylactic matching. Phenotyping in this patient population is often hindered by the presence of circulating donor cells and/or by a positive DAT. Several methods, such as EDTA glycine acid (EGA) treatment to remove IgG, hypotonic saline wash to separate autologous RBCs, or reticulocyte separation, are often used in these situations to isolate patient RBCs for serologic phenotyping...
December 2017: Immunohematology
https://www.readbyqxmd.com/read/29043831/del-phenotype
#13
Dong H Kwon, S G Sandler, Willy A Flegel
DEL red blood cells (RBCs) type as D- by routine serologic methods and are transfused routinely, without being identified as expressing a very weak D antigen, to D- recipients. DEL RBCs are detected only by adsorption and elution of anti-D or by molecular methods. Most DEL phenotypes have been reported in population studies conducted in East Asia, although DEL phenotypes have been detected also among Caucasian individuals. Approximately 98 percent of DEL phenotypes in East Asians are associated with the RHD*DEL1 or RHD*01EL...
September 2017: Immunohematology
https://www.readbyqxmd.com/read/29043830/red-blood-cell-phenotype-prevalence-in-blood-donors-who-self-identify-as-hispanic
#14
Chelsea A Sheppard, Nicole L Bolen, Beth Eades, Gorka Ochoa-Garay, Mark H Yazer
Molecular genotyping platforms provide a quick, high-throughput method for identifying red blood cell units for patients on extended phenotype-matching protocols, such as those with sickle cell disease or thalassemia. Most of the antigen prevalence data reported are for non-Hispanic populations. Therefore, this study sought to determine the phenotype prevalence in a single blood center's Hispanic population and to compare those results with previously reported rates in non-Hispanic donor populations. We performed a retrospective review of all serologic and molecular typing from donors who self-reported as Hispanic...
September 2017: Immunohematology
https://www.readbyqxmd.com/read/29043829/postpartum-acute-hemolytic-transfusion-reactions-associated-with-anti-lea-in-two-pregnancies-complicated-by-preeclampsia
#15
Marcia Marchese
Lewis blood group antibodies, which are mostly naturally occurring and considered clinically insignificant, have rarely been documented as a cause of acute hemolytic transfusion reactions (AHTRs). This report presents two cases of AHTRs caused by anti-Lea occurring in postpartum black females (one group B, one group AB) whose pregnancies were complicated by preeclampsia. Neither anti-Lea was detected by automated solid-phase red cell adherence technology in pre-transfusion testing. Therefore, red blood cell units, compatible by electronic crossmatch, were issued and transfused...
September 2017: Immunohematology
https://www.readbyqxmd.com/read/29043828/a-lu-16-individual-with-antibodies
#16
Carole Éthier, Cynthia Parent, Anne-Sophie Lemay, Nadia Baillargeon, Geneviève Laflamme, Josée Lavoie, Josée Perreault, Maryse St-Louis
Antibodies against Lutheran blood group antigens have been observed during first-time pregnancy. Samples from a woman of African descent were tested in our immunohematology laboratory on several occasions since 2001. Her samples were phenotyped as Lu(a+b-), and anti-Lub was suspected but not identified. She was asked to make autologous donations in preparation for her delivery, which she did. In 2010, two antibodies were identified: anti-Lea and -Lub. Six years later, a third investigation was requested. This time, an antibody directed at a high-prevalence Lutheran antigen was found in addition to the anti-Lea and -Lub previously observed...
September 2017: Immunohematology
https://www.readbyqxmd.com/read/29043827/stability-guidelines-for-dithiothreitol-treated-red-blood-cell-reagents-used-for-antibody-detection-methods-in-patients-treated-with-daratumumab
#17
Wendy L Disbro
Daratumumab (DARA), a drug used to treat patients with multiple myeloma, causes interference in pre-transfusion testing. Samples from patients receiving DARA exhibit panreactivity in antibody detection and identification tests with red blood cells (RBCs). Many hospitals are sending these samples to reference laboratories. Dithiothreitol (DTT), a sulfhydryl chemical treatment of RBCs, negates this reactivity. This study investigated the stability of the antigens on DTT-treated RBCs to determine if large quantities of RBCs could be treated at one time, stored, and used for testing at a later time...
September 2017: Immunohematology
https://www.readbyqxmd.com/read/29043826/abo-serology-in-a-case-of-persistent-weak-a-in-a-recipient-following-a-group-o-matched-unrelated-bone-marrow-transplant
#18
Dianne E Grey, Elizabeth A Fong, Catherine Cole, Jesper Jensen, Jill Finlayson
HLA-matched hematopoietic stem cell transplantation (HSCT) from red blood cell (RBC)-incompatible donors is not uncommon. The engraftment process following ABO-incompatible allogeneic HSCT results in the transition from patient blood group to donor blood group in the recipient. In contrast, most non-hematopoietic tissues retain expression of the patient's original blood group for life, and these antigens may adsorb from the plasma onto the donor-derived RBCs. Correct serologic interpretation of the ABO blood group during this engraftment process can be difficult...
September 2017: Immunohematology
https://www.readbyqxmd.com/read/28657768/bloody-brilliant-a-history-of-blood-groups-and-blood-groupers
#19
S G Sandler
What a joy and privilege to read and reread this unique and extraordinarily informative history for this review! Pierce and Reid have authored a 633-page, 28-chapter tome, containing 796 illustrations, including photographs of individual contributors to the field of blood group serology, as well as group photographs of landmark meetings and conferences held during the past 100 years. The Index lists the names of 1046 individuals who are acknowledged as contributors to the history of blood group serology, many of whom are the subject of cameo biographies...
June 2017: Immunohematology
https://www.readbyqxmd.com/read/28657767/recognizing-and-resolving-abo-discrepancies
#20
Geralyn M Meny
Patient samples are routinely typed for ABO prior to transfusion. Determining the ABO group requires both red blood cell (RBC) antigen typing for A and B (forward type) and testing for anti-A and anti-B in the plasma (reverse type). An ABO discrepancy exists when the result of an ABO RBC typing, or forward type, does not agree with the result of the plasma typing, or reverse type. This brief review examines several causes of ABO discrepancies encountered in the clinical transfusion service. Options for resolving these discrepancies are presented, including a discussion of which discrepancies should be resolved using molecular testing...
June 2017: Immunohematology
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