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High incidence alloantibody

Patricia A R Brunker, Keerthana Ravindran, R S Shirey
Alloimmunization to red blood cell antigens is unpredictable and poorly understood. Patients who are negative for high-incidence antigens (HIAs) are at risk for developing the corresponding antibodies. Molecular methods can easily predict the lack of an antigen and thus, the risk of an individual to become immunized. We examined the prevalence and risk factors for HIA alloimmunization in patients at risk based on genotyping results. Genotyping using a molecular method (HEA BeadChip™, Immucor, Warren, NJ) was performed on all patient specimens referred for molecular testing over 45 months; serologic and clinical data were analyzed...
January 2017: Immunohematology
Ehsan Shahverdi, Mostafa Moghaddam, Fateme Gorzin
BACKGROUND: The objective was to determine the frequency of occurrence of alloantibodies among pregnant women in Iran. STUDY DESIGN AND METHODS: This was a prospective cross-sectional study, which was carried out in the immunohematology reference laboratory of the Iranian Blood Transfusion Organization in Tehran, Iran, in 2008 to 2015. Screening and identification of red blood cell (RBC) alloantibodies was done on the sera of 7340 pregnant females using the standard tube method and gel column agglutination technique...
January 2017: Transfusion
Flora Peyvandi, Pier M Mannucci, Isabella Garagiola, Amal El-Beshlawy, Mohsen Elalfy, Vijay Ramanan, Peyman Eshghi, Suresh Hanagavadi, Ramabadran Varadarajan, Mehran Karimi, Mamta V Manglani, Cecil Ross, Guy Young, Tulika Seth, Shashikant Apte, Dinesh M Nayak, Elena Santagostino, Maria Elisa Mancuso, Adriana C Sandoval Gonzalez, Johnny N Mahlangu, Santiago Bonanad Boix, Monica Cerqueira, Nadia P Ewing, Christoph Male, Tarek Owaidah, Veronica Soto Arellano, Nathan L Kobrinsky, Suvankar Majumdar, Rosario Perez Garrido, Anupam Sachdeva, Mindy Simpson, Mathew Thomas, Ezio Zanon, Bulent Antmen, Kaan Kavakli, Marilyn J Manco-Johnson, Monica Martinez, Esperanza Marzouka, Maria G Mazzucconi, Daniela Neme, Angeles Palomo Bravo, Rogelio Paredes Aguilera, Alessandra Prezotti, Klaus Schmitt, Brian M Wicklund, Bulent Zulfikar, Frits R Rosendaal
BACKGROUND: The development of neutralizing anti-factor VIII alloantibodies (inhibitors) in patients with severe hemophilia A may depend on the concentrate used for replacement therapy. METHODS: We conducted a randomized trial to assess the incidence of factor VIII inhibitors among patients treated with plasma-derived factor VIII containing von Willebrand factor or recombinant factor VIII. Patients who met the eligibility criteria (male sex, age <6 years, severe hemophilia A, and no previous treatment with any factor VIII concentrate or only minimal treatment with blood components) were included from 42 sites...
May 26, 2016: New England Journal of Medicine
László Muszbek, Éva Katona
Inherited deficiency of FXIII A subunit (FXIII-A) is a rare (1:2,000,000) but very severe bleeding diathesis. The incidence is much higher in communities where the practice of consanguineous marriage is combined with founder effect mutation. Because of the high risk of intracranial bleeding, life-long prophylaxis, preferably using FXIII concentrate, is mandatory. In FXIII-B subunit deficiency the bleeding diathesis is mild to moderate. FXIII deficiency is frequently associated with impaired wound healing. Women suffering from FXIII deficiency cannot carry pregnancies to term; in severe cases spontaneous abortion occurs in the first trimester...
June 2016: Seminars in Thrombosis and Hemostasis
Peter T W Kim, Anthony J Demetris, Jacqueline G O'Leary
PURPOSE OF REVIEW: The review outlines the diagnosis, prevention strategies, and possible treatment options for acute and chronic antibody-mediated rejection (AMR). RECENT FINDINGS: Although rare, severe acute AMR (aAMR) usually occurs in patients with high mean fluorescence intensity despite serial dilutions or high-titer preformed class I donor-specific alloantibodies (DSA). The diagnosis is suspected when allograft dysfunction occurs with DSA, diffuse C4d staining, and a microvascular injury, and may be aided by the aAMR score...
April 2016: Current Opinion in Organ Transplantation
Roberto de Oliveira Cruz, Mariza Aparecida Mota, Fabiana Mendes Conti, Ricardo Antônio d'Almeida Pereira, Jose Mauro Kutner, Maria Giselda Aravechia, Lilian Castilho
OBJECTIVE: To determine the incidence and the rate of red blood cell alloimmunization in polytransfused patients. METHODS: A polytransfused patient was defined as having received at least 6 units of red cell concentrates during a 3-month period. The records of all patients (n = 12,904) who had received red blood cell units were examined retrospectively by searching the computer database at Hospital Israelita Albert Einstein in São Paulo, Brazil, over a 6-year period, between 2003 and 2009...
June 2011: Einstein
Yingzi Ming, Juan Hu, Qizhi Luo, Xiang Ding, Weiguang Luo, Quan Zhuang, Yizhou Zou
The presence of donor-specific alloantibodies (DSAs) against the MICA antigen results in high risk for antibody-mediated rejection (AMR) of a transplanted kidney, especially in patients receiving a re-transplant. We describe the incidence of acute C4d+ AMR in a patient who had received a first kidney transplant with a zero HLA antigen mismatch. Retrospective analysis of post-transplant T and B cell crossmatches were negative, but a high level of MICA alloantibody was detected in sera collected both before and after transplant...
2015: PloS One
Thomas Braschler, Cora Alexandra Vökt, Hein Hustinx, Thierry Peyrard, Laura Infanti, Andreas Buser, Andreas Holbro
BACKGROUND: Holley (Hy) is a high-incidence antigen of the Dombrock blood group system (ISBT 014), present in almost 100% of most populations and more than 99% of Blacks. Since anti-Hy is an extremely rare antibody, data on its clinical relevance and in particular on a possible hemolytic disease of the fetus and newborn (HDFN) are scarce. CASE REPORT: The pregnant patient underwent two autologous whole blood collections at weeks 17 and 19 of gestation with cryopreservation...
March 2015: Transfusion Medicine and Hemotherapy
Yona Mbalibulha, Enoch Muwanguzi, Godfrey R Mugyenyi, Bernard Natukunda
OBJECTIVES: This study was undertaken to determine the distribution of ABO/RhD (rhesus D antigen) blood phenotypes, prevalence of anti-D alloantibodies, and the risk factors for alloimmunization among pregnant women in Kasese District, Western Uganda. MATERIALS AND METHODS: Ethylenediamine tetraacetic acid-containing plasma samples and serum samples were taken from pregnant women attending the antenatal clinic. The blood groups were identified using the microplate grouping method, while the presence of anti-D alloantibodies was detected by the indirect antiglobulin test (IAT)...
2015: Journal of Blood Medicine
Thomas Bachelet, Celine Nodimar, Jean-Luc Taupin, Sebastien Lepreux, Karine Moreau, Delphine Morel, Gwendaline Guidicelli, Lionel Couzi, Pierre Merville
Outcome of patients with transplant glomerulopathy (TG) is poor. Using B-cell targeting molecules represent a rational strategy to treat TG during chronic antibody-mediated rejection. In this pilot study, 21 patients with this diagnosis received four doses of intravenous immunoglobulins and two doses of rituximab (IVIG/RTX group). They were retrospectively compared with a untreated control group of 10 patients. At 24 months post-biopsy, graft survival was similar and poor between the treated and the untreated group, 47% vs...
May 2015: Clinical Transplantation
Farheen Karim, Bushra Moiz, Nausheen Kamran
BACKGROUND: Haemolytic disease of the fetus and the newborn [HDFN] is caused by incompatibility of maternal and fetal erythrocytes. Red blood cell alloimmunization is a well-known cause of HDFN. Due to heterogeneity of populations, the spectrum of alloimmunization varies around the world. This study aimed to determine the frequency of alloimmunization in pregnant women and to determine the risk of HDFN in our population. STUDY DESIGN AND METHODS: This was a descriptive study conducted at Aga Khan University Hospital Karachi...
February 2015: Transfusion and Apheresis Science
Shamsuz Zaman, Rahul Chaurasia, Kabita Chatterjee, Rakesh Mohan Thapliyal
Background. Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. Data about alloimmunization rate in general patient population is scarce especially from resource limited countries. We undertook this study to determine prevalence and specificity of RBC alloantibodies in patients admitted in various clinical specialties at a tertiary care hospital in North India. Methods. Antibody screening was carried out in 11,235 patients on automated QWALYS 3 platform (Diagast, Loos, France)...
2014: Advances in Hematology
Charlotte R Bell, Morag G Kerr, Philip R Scott, W Ivan Morrison, Helen Brown
BACKGROUND: Bovine Neonatal Pancytopenia (BNP) is a disease of calves characterised by bone marrow trilineage hypoplasia, mediated by ingestion of alloantibodies in colostrum. Suspected subclinical forms of BNP have been reported, suggesting that observed clinical cases may not represent the full extent of the disease. However to date there are no objective data available on the incidence of subclinical disease or its temporal distribution. This study aimed to 1) ascertain whether subclinical BNP occurs and, if so, to determine the incidence on an affected farm and 2) determine whether there is evidence of temporal clustering of BNP cases on this farm...
October 8, 2014: BMC Veterinary Research
M Hayes
This review describes the current state of knowledge of the Raph blood group system, which consists of a single antigen, MER2. MER2 was initially classified as a high-incidence antigen in the 901 series of blood groups, formerly known as 901011, but was reclassified as an antigen in the Raph blood group system in 2004. There have been six reports of human alloantibodies to MER2. Three of the subjects were found to have a stop codon in the CD151 gene, which encodes a member of the tetraspanin family of proteins...
2014: Immunohematology
Andrew Bentall, Dolly B Tyan, Flavia Sequeira, Matthew J Everly, Manish J Gandhi, Lynn D Cornell, Han Li, Nicole A Henderson, Suresh Raghavaiah, Jeffrey L Winters, Patrick G Dean, Mark D Stegall
Terminal complement blockade has been shown to decrease the incidence of early acute antibody-mediated rejection (eAMR) in the first month after positive cross-match kidney transplant recipients, yet some patients still develop eAMR. The current study investigated possible mechanisms of eAMR despite eculizumab treatment. Of the 26 patients treated with eculizumab, two developed clinical eAMR and another patient developed histologic signs of eAMR without graft dysfunction ('subclinical eAMR'). Twenty-three did not have histologic injury on early surveillance biopsies...
December 2014: Transplant International: Official Journal of the European Society for Organ Transplantation
Lisa E E L O Lashley, Marie-Louise P van der Hoorn, Geert W Haasnoot, Dave L Roelen, Frans H J Claas
BACKGROUND: Fetuses in pregnancies conceived after oocyte donation (OD) have a higher degree of antigeneic dissimilarity with the mother compared to semi-allogeneic fetuses after natural conception. We questioned whether this leads to higher level of HLA antibody formation in OD pregnancies. METHOD: Uncomplicated pregnancies after OD were compared with pregnancies conceived either spontaneously or by IVF. We calculated the number of HLA- and epitope mismatches. Maternal sera were screened for HLA antibodies with ELISA; child HLA specific antibody production was determined using CDC and Luminex with single antigen beads for class I and II...
June 2014: Human Immunology
Rabeya Yousuf, Suria Abdul Aziz, Nurasyikin Yusof, Chooi Fun Leong
Red blood cell alloimmunization is a common complication among the transfusion recipients. In Malaysia, multiple ethnicity causes genetic heterogeneity among the population which in turn can cause a wide variation of antibody. The objective of this study was to analyse the red cell alloantibody detected during the pre-transfusion testing. This was a cross-sectional study done in the blood bank of Universiti Kebangsaan Malaysia Medical Centre during the period of January-December 2010. The data was retrieved from the hospital laboratory information system...
June 2013: Indian Journal of Hematology & Blood Transfusion
Giuseppe Tagariello, Alfonso Iorio, Davide Matino, Donata Belvini, Roberta Salviato, Roberto Sartori, Paolo Radossi
BACKGROUND: The natural history of inhibitors in patients with haemophilia A not undergoing immune tolerance induction (ITI) is largely unknown. A recent randomized controlled trial suggests that the higher the FVIII dose used for ITI, the faster the clearance and the lower the rate of bleeding, without any difference in the rate of tolerance. We aimed at assessing the rate of spontaneous inhibitor clearance in a large cohort of patients not undergoing ITI. METHODS: A retrospective analysis of anti-FVIII inhibitors of long-term registry data in a single centre cohort of 524 haemophilia A patients considered for synovectomy was performed...
2013: Journal of Hematology & Oncology
M Xi, M Makris, M Marcucci, E Santagostino, P M Mannucci, A Iorio
BACKGROUND: The development of neutralizing alloantibodies (inhibitors) is the most serious complication of factor VIII (FVIII) replacement therapy in patients with hemophilia A. Unlike previously untreated patients, no definite risk factors for inhibitor development are known for previously treated patients (PTPs). The investigation of the development of inhibitors in PTPs is hindered by several methodological limitations in the available literature. We conducted a systematic review to account for these limitations...
September 2013: Journal of Thrombosis and Haemostasis: JTH
M Banasik, M Boratyńska, K Kościelska-Kasprzak, O Mazanowska, D Bartoszek, M Zabińska, M Myszka, B Nowakowska, A Hałoń, P Szyber, D Patrzałek, M Klinger
BACKGROUND: Detection of antibody-mediated injury is becoming increasingly important in post-transplant patient care. The role of donor-specific anti-human leukocyte antigen (HLA) antibodies in kidney transplant damage is known, whereas the significance of non-HLA antibodies remains an unresolved concern. The aim of the study was to determine the presence and influence on renal function of non-HLA and anti-HLA antibodies in stable patients at 5 years after kidney transplantation. METHODS: We evaluated the antibodies in 35 consecutive patients with stable renal function at 5 years after transplantation...
May 2013: Transplantation Proceedings
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