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Immunohematology

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https://www.readbyqxmd.com/read/29989422/clinically-significant-naturally-occurring-anti-n-and-anti-s-in-a-blood-donor-a-rare-finding
#1
Sheetal Malhotra, Gita Negi, Aseem K Tiwari
To the Editors: Alloimmunization is triggered when an individual whose red blood cells (RBCs) are lacking particular antigens is exposed to these antigens through transfusion or pregnancy, causing the formation of immune antibodies. In addition to these exogenous exposures, underlying inflammatory or autoimmune conditions may lead to formation of unexpected antibodies. Individual factors also play a role, since some people are responders and others are non-responders. We report a case of naturally occurring alloanti-N and alloanti-S in a healthy D+ blood donor...
June 2018: Immunohematology
https://www.readbyqxmd.com/read/29989421/rh-and-kell-blood-group-antigen-prevalence-in-a-multi-ethnic-cohort-in-nigeria-implications-for-local-transfusion-service
#2
Ademola S Adewoyin, Grace M Lee, Titilope A Adeyemo, Omolade A Awodu
Antigens belonging to the Rh and Kell blood group systems are of major clinical significance because of their immunogenicity and the potential of their consequent antibodies to cause in vivo destruction of exogenous red blood cells (RBCs). Despite the wide-spread use of transfusion, there are sparse data on the prevalence of Rh and Kell system antigens and their ethnic variability in Nigeria. The objective of this study was to determine the prevalence of the five major Rh (D, C, c, E, e) and Kell (K) system antigens in Nigeria with the goal of understanding alloimmunization risk in transfusion recipients and improving transfusion safety through the availability of resources, such as antisera for extended RBC typing and antigen panels for alloantibody detection...
June 2018: Immunohematology
https://www.readbyqxmd.com/read/29989420/low-ionic-strength-saline-solution-antiglobulin-test-liss-agt
#3
LeeAnn Walker
The use of low-ionic-strength saline (LISS) solution as an enhancement for antibody screening and crossmatching was first described by Löw and Messeter in 1974. This method allowed for a reduced incubation time while maintaining adequate specificity and sensitivity of the antiglobulin test (AGT). Since then, the LISS-AGT tube method has been widely used in antibody detection and identification, as well as compatibility testing. As initially described, the method used red blood cells suspended in LISS. Modifications of the method led to development of the commercially prepared LISS additive solutions in use today...
June 2018: Immunohematology
https://www.readbyqxmd.com/read/29989419/mixed-field-agglutination-observed-in-column-agglutination-testing-is-not-always-associated-with-the-a3-subgroup
#4
Nampeung Anukul, Nipapan Leetrakool, Praijit Tanan, Poonsub Palacajornsuk, Phennapha Klangsinsirikul
Mixed-field agglutination (MFA) can be observed in forward typing of samples from A3 individuals with serologic ABO typing methods. The results of column agglutination testing (CAT) and tube agglutination testing using different antibody clones can be discordant. In this report, we reveal our experience using polymerase chain reaction-sequence-based typing (PCR-SBT) of ABO exon 7 to clarify serologic method discordance of A subgroup blood typing in Northern Thai donors. A total of 21 group A blood donors with either MFA or weak agglutination on routine ABO CAT were recalled...
June 2018: Immunohematology
https://www.readbyqxmd.com/read/29989418/adsorption-of-cold-agglutinins-with-rabbit-red-blood-cells
#5
Adam Cobaugh
Cold-reactive autoagglutinins may mask the presence of underlying clinically significant alloantibodies. Adsorption with rabbit red blood cells (RBCs) or stroma can remove cold autoagglutinins found in the patient's plasma/serum that are directed towards antigens expressed on the surface of rabbit RBCs. By removing these cold autoagglutinins, it is then possible to determine whether any underlying alloantibody reactivity is present. Although this method may also unintentionally adsorb alloantibodies directed towards antigens found on rabbit RBCs, it is still a widely used and convenient method to remove cold autoagglutinins...
June 2018: Immunohematology
https://www.readbyqxmd.com/read/29989417/clinical-significance-of-antibodies-to-antigens-in-the-international-society-of-blood-transfusion-collections-700-series-of-low-incidence-antigens-and-901-series-of-high-incidence-antigens
#6
Christine Lomas-Francis
This article reviews information regarding the clinical significance of antibodies to antigens in the blood group collections, the 700 series of low-incidence antigens, and the 901 series of high-incidence antigens. Antibodies to many of the antigens in these groups are rarely encountered, meaning that available information is limited. For a few, the clinical significance-the potential to cause reduced survival of transfused antigen-positive red blood cells, a hemolytic transfusion reaction (e.g., anti-AnWj, anti-Emm), or hemolytic disease of the fetus and newborn (e...
June 2018: Immunohematology
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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