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Raj Nath Makroo, Saroj Rajput, Soma Agarwal, Mohit Chowdhry, Bindu Prakash, Prashant Karna
BACKGROUND: Alloantibodies may be detected in blood donors who have either been transfused previously or female donors with previous obstetric events. These antibodies can occasionally cause severe transfusion reaction, if a large amount of plasma or whole blood is transfused, as in massive transfusions and pediatric patients. AIMS: The present study aims to assess the prevalence of red cell antibodies in healthy blood donors at a tertiary care hospital-based blood bank in India...
January 2018: Asian Journal of Transfusion Science
Raghad Mubarak Aljuhaysh, Nagah Mohamed Abo El-Fetoh, Malak Ibrahim Alanazi, Afaf Shuaib Albaqawi, Wafa Mohammed Alanazi, Najah Salah Alanazi, Reham Muqbil Alanazi, Atheer Mutab Alanazi, Eiman Mohammad Alnemer, Rahma Abdulhadi Alenezi, Tasleem Khoudier Alabdullatif, Rehab Abdallah Alanazi, Samiyah Sarhan Alanazi, Kawthar Saeed Alsultan, Ibtisam Matan Alanazi, Duaa Sami Alsunayni
Background and aim: Rh isoimmunization still contributes to the neonatal morbidity and mortality due to non-immunization, under-immunization, and in rare cases, false Rh typing. The main objective of this study was to determine the prevalence of Rh incompatibility, mothers' knowledge about Rh incompatibility, mothers' knowledge about anti-D immunoglobulin and to show the pregnancy outcome of Rh negative mothers. Methods: A cross-sectional study was carried out at the Maternity and Children Hospital in Arar city from November 2016 to May 2017...
December 2017: Electronic Physician
Ahmad Yaseen, Sa'd Suleiman, Omar Abu Zenah, Adham Abu Taha
BACKGROUND: Red blood-cell transfusion has greatly reduced the mortality and morbidity in multiply transfused patients with thalassaemia and sickle cell disease. However, this can result in red blood-cell isoimmunisation with autoantibodies and alloantibodies, which can lead to serious complications such as delayed haemolytic transfusion reaction. The aim of this study was to assess the frequency and types of alloantibodies in multiply transfused patients living in the north of the West Bank...
February 21, 2018: Lancet
Yolentha Maria Slootweg, Johanna Maria Koelewijn, Wim L de Kort, Masja de Haas, Eva-Maria Merz
BACKGROUND: The successful introduction of prophylaxis with anti-RhD immunoglobulin has resulted in a significant decline of pregnancy-related RhD immunizations but also has decreased the availability of naturally immunized women as (new) anti-D donors. An influx of new donors is necessary to maintain a sufficient pool of anti-D donors. We investigated motivators, barriers, and predictors for anti-D donorship in RhD-immunized women. STUDY DESIGN AND METHODS: A mixed-methods design was applied, including focus group discussions and questionnaires...
March 12, 2018: Transfusion
Jiao Wang, Jingjing Song, Shuimei Zhou, Yourong Fu, Jeffrey A Bailey, Changxin Shen
BACKGROUND: Identification of RhD antigen epitopes is a key component in understanding the pathogenesis of haemolytic disease of the foetus and newborn. Research has indicated that phage display libraries are useful tools for identifying novel mimic epitopes (mimotopes) which may help to determine antigen specificity. MATERIALS AND METHODS: We selected the mimotopes of blood group RhD antigen by affinity panning a phage display library using monoclonal anti-D. After three rounds of biopanning, positive phage clones were identified by enzyme-linked immunosorbent assay (ELISA) and then sent for sequencing and peptides synthesis...
January 16, 2018: Blood Transfusion, Trasfusione del Sangue
Thanh-Vy Phung, Véronique Houfflin-Debarge, Nassima Ramdane, Louise Ghesquière, Anne Delsalle, Capucine Coulon, Damien Subtil, Pascal Vaast, Charles Garabedian
BACKGROUND: The antibody primarily responsible for fetal anemia may influence treatment and prognosis. The primary objective was to compare ante- and postnatal management and the outcomes of maternal red blood cell (RBC) alloimmunizations according to the antibody involved. The secondary objective was to compare anti-D alloimmunizations according to associated number of antibodies. STUDY DESIGN AND METHODS: A single-center study from 1999 to 2015 including maternal RBC alloimmunizations requiring intrauterine transfusion (IUT) was conducted...
March 6, 2018: Transfusion
S Mu, Y Cui, W Wang, L Wang, H Xu, O Zhu, D Zhu
OBJECTIVES: The aim of this study was to characterise a novel mutation in the gene encoding RhAG in order to elucidate a molecular mechanism for Rh antigen expression and spherocytosis. BACKGROUND: Rhesus-associated glycoprotein (RhAG) is critical for maintaining the structure and stability of erythrocytes. Single missense mutations in the gene encoding RhAG are sufficient to induce spherocytosis and deficiencies in Rh complex formation. We report a novel missense mutation that incompletely disrupts Rh antigen expression and selectively knocks out RhD antigen expression...
March 6, 2018: Transfusion Medicine
Emine Demirel, Sefa Kelekçi, Emre Ekmekci, Mustafa Şengül, Raziye İri, Melahat Atasever
Background/aim: The aim of this study was to assess unnecessary immunization rates and compare the cost-effectiveness of targeted prophylaxis with fetal Rh genotyping with that of traditional management of Rh-Rh incompatibility in a virtual economic model. Materials and methods: This retrospective data analysis was conducted at two tertiary centers between 2011 and 2015. The data of 1135 pregnant women were analyzed. The main outcome measure was to determine the unnecessary immunization rate among the whole Rh-Rh incompatibility group...
February 23, 2018: Turkish Journal of Medical Sciences
Pedro Saramago, Huiqin Yang, Alexis Llewellyn, Stephen Palmer, Mark Simmonds, Susan Griffin
OBJECTIVE: To evaluate the cost-effectiveness of high-throughput, non-invasive prenatal testing (HT-NIPT) for fetal RhD genotype to guide antenatal prophylaxis with anti-D immunoglobulin compared to routine antenatal anti-D immunoglobulin prophylaxis (RAADP). DESIGN: Cost-effectiveness decision-analytic modelling. SETTING: Primary care. PARTICIPANTS: A simulated population of 100,000 RhD negative women not known to be sensitised to the RhD antigen...
February 7, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Elena D Cabrera, Elena Carretón, Rodrigo Morchón, Yaiza Falcón-Cordón, Soraya Falcón-Cordón, Fernando Simón, J Alberto Montoya-Alonso
We assessed the risk of human pulmonary dirofilariasis in the Canary Islands, hyperendemic for canine heartworm (Dirofilaria immitis), a zoonotic vector-borne infection. For this purpose, 1479 inhabitants were tested for anti-D. immitis antibodies. Four of the 7 islands presented high seroprevalences (from 6.2 to 12.7%), therefore high exposure to the parasite and risk of zoonotic infection. These corresponded to those islands with high canine prevalences of dirofilariasis and favourable climatic conditions for the development of mosquito vectors...
March 2018: Parasitology Research
Senaka Rajapakse, Nipun Lakshitha de Silva, Praveen Weeratunga, Chaturaka Rodrigo, Sumadhya Deepika Fernando
The global incidence of dengue has increased sevenfold between 1990 and 2013. Despite a low case fatality rate (<1%), during epidemics, due to the large number of people affected, overall mortality rates can be significant. The risk of clinically significant bleeding in dengue is unpredictable and often contributes to an adverse outcome. This systematic review focuses on the evidence for prophylactic and therapeutic interventions for bleeding in dengue infection. PubMed, CINAHL, Cochrane Library, Embase and Google Scholar were searched for randomized, quasi-randomized and non-randomized, prospective or retrospective studies that had a control group alongside an intervention aimed at stopping or preventing bleeding in dengue infection...
January 29, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
B S Erikstein, K G Hagen, T Hervig
BACKGROUND AND OBJECTIVE: Although several studies focus on red blood cell (RBC) alloantibody distribution in selected patient populations, few address the specificity and frequency in all relevant groups. This study reports alloantibody frequency, distribution and the relationship to age and gender in blood donors, pregnant women and potential recipients of blood products. METHODS: This historical cohort study included 55 462 consecutive antibody screening tests from a tertiary Western Norwegian Hospital...
January 29, 2018: Transfusion Medicine
Yoelys Cruz-Leal, Danielle Marjoram, Alan H Lazarus
Anti-D prevents hemolytic disease of the fetus and newborn, and this mechanism has been referred to as Ab-mediated immune suppression (AMIS). Anti-D, as well as other polyclonal AMIS-inducing Abs, most often induce both epitope masking and erythrocyte clearance mechanisms. We have previously observed that some Abs that successfully induce AMIS effects could be split into those that mediate epitope masking versus those that induce erythrocyte clearance, allowing the ability to analyze these mechanisms separately...
January 22, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
Khalid S Khan, Philip Moore, Matthew Wilson, Richard Hooper, Shubha Allard, Ian Wrench, Tracy Roberts, Carol McLoughlin, Lee Beresford, James Geoghegan, Jane Daniels, Sue Catling, Vicki A Clark, Paul Ayuk, Stephen Robson, Fang Gao-Smith, Matthew Hogg, Louise Jackson, Doris Lanz, Julie Dodds
BACKGROUND: Caesarean section is associated with blood loss and maternal morbidity. Excessive blood loss requires transfusion of donor (allogeneic) blood, which is a finite resource. Cell salvage returns blood lost during surgery to the mother. It may avoid the need for donor blood transfusion, but reliable evidence of its effects is lacking. OBJECTIVES: To determine if routine use of cell salvage during caesarean section in mothers at risk of haemorrhage reduces the rates of blood transfusion and postpartum maternal morbidity, and is cost-effective, in comparison with standard practice without routine salvage use...
January 2018: Health Technology Assessment: HTA
Karen Fung Kee Fung, Erica Eason
OBJECTIVE: To provide guidelines on use of anti-D prophylaxis to optimize prevention of rhesus (Rh) alloimmunization in Canadian women. OUTCOMES: Decreased incidence of Rh alloimmunization and minimized practice variation with regards to immunoprophylaxis strategies. EVIDENCE: The Cochrane Library and MEDLINE were searched for English-language articles from 1968 to 200 I, relating to the prevention of Rh alloimmunization. Search terms included: Rho(D) immune globulin, Rh iso- or aile-immunization, anti-D, anti-Rh, WinRho, Rhogam, and pregnancy...
January 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Laura C Nwogu, Kenneth J Moise, Kimberly L Klein, Hlaing Tint, Brian Castillo, Yu Bai
BACKGROUND: Antibodies to Rhesus and Kell antigens have been associated with severe hemolytic disease of the fetus and newborn (HDFN) necessitating intrauterine transfusion (IUT) of red blood cells (RBCs). We report a case series of five women with severe HDFN secondary to maternal RBC alloimmunization who were successfully managed with therapeutic plasma exchange (TPE), intravenous immune globulin (IVIG), and IUT. STUDY DESIGN AND METHODS: This is a retrospective case series of five women with severe HDFN who underwent a total of three TPE procedures during Weeks 10 to 13 of pregnancy, followed by weekly IVIG infusions...
December 17, 2017: Transfusion
Preeti Rai, Geetika Sharma, Deeksha Singh, Jyoti Garg
The Rhesus G antigen is present on all RBCs that are C+ and also on most D+ RBCs. Due to this co-distribution of G with either C or D antigen, it mimics a reactivity pattern of anti C + anti D on Indirect Antiglobulin Test (IAT), though the role of Anti G in causing Hemolytic Disease of Newborn (HDN) is controversial. The differentiation of anti D, anti C, and anti G is essential particularly in pregnant females. We hereby report a rare case of anti G with anti D and anti C in a pregnant woman with emphasis on approach to identify anti D+C+G and its implications...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
Thomas H P M Habets, Joris Vanderlocht, Ron J M H E Straat, Tim C van Smaalen, Gerard M J Bos, Erik A Beckers, Maarten H L Christiaans, Yvonne M C Henskens
BACKGROUND: D antigens are not taken into account in the allocation of solid organs. Female transplant recipients with D antibodies as a consequence of D-mismatched kidney transplantation may develop hemolytic disease of the fetus and newborn in future pregnancies. We examined D antibody development in transplant recipients who received D-mismatched kidney transplantation in absence of D prophylaxis and in a setting of reduced immunosuppression. STUDY DESIGN AND METHODS: From 1993 until 2015, a total of 1355 kidney patients received transplantations in our center of whom 156 received a D-mismatched graft...
January 2018: Transfusion
Cécile Toly-Ndour, Haifa Mourtada, Stéphanie Huguet-Jacquot, Emeline Maisonneuve, Stéphanie Friszer, Françoise Pernot, Pauline Thomas, Jean-Marie Jouannic, Bruno Carbonne, Anne Cortey, Agnès Mailloux
BACKGROUND: In addition to titration by indirect antiglobulin test most widely used, anti-D quantitation by continuous-flow analysis (CFA) may be performed to assess severity of maternal immunization. Only five studies have reported its added value in the management of pregnancies complicated by anti-D immunization. STUDY DESIGN AND METHODS: A retrospective study of 74 severe anti-D-immunized pregnancies was conducted from January 1, 2013, to December 31, 2014, in the Trousseau Hospital in Paris (France)...
February 2018: Transfusion
Lauren Andersson, Ferenc Szabo
BACKGROUND: Haemolytic disease of the fetus/newborn secondary to clinically significant non-Rhesus-D antibodies has risen in importance since the advent of immunoprophylactic anti-D administration to Rhesus-D negative women. Of interest is the incidence of these antibodies in Rhesus-D positive women, who receive less frequent antenatal alloantibody screening. This is of particular concern if the antibodies arise late in pregnancy and may go undetected. AIMS: To assess the proportion of Rhesus-D positive pregnant women with late developing clinically significant antibodies for haemolytic disease of the fetus/newborn, and whether these resulted in adverse fetal outcomes...
November 28, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
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