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Red cell alloimmunization

Prabitha Natarajan, Jingchun Liu, Manjula Santhanakrishnan, David R Gibb, Lewis M Slater, Jeanne E Hendrickson
BACKGROUND: Few therapeutic options currently exist to prevent or to mitigate transfusion-associated red blood cell (RBC) alloimmunization. We hypothesized that bortezomib, a proteasome inhibitor currently being utilized for HLA alloantibody and ADAMTS13 autoantibody reduction, may be beneficial in a transfusion setting. Herein, we utilized a reductionist murine model to test our hypothesis that bortezomib would decrease RBC alloimmune responses. STUDY DESIGN AND METHODS: Wild-type mice were treated with bortezomib or saline and transfused with murine RBCs expressing the human KEL glycoprotein...
October 13, 2016: Transfusion
Carolien Zwiers, Irene T M Lindenburg, Frans J C M Klumper, Masja de Haas, Dick Oepkes, Inge L van Kamp
BACKGROUND: maternal alloimmunization to fetal red blood cell antigens is a major cause of fetal anemia, which in untreated cases can lead to hydrops and perinatal death. The cornerstone of the management during pregnancy is intrauterine intravascular blood transfusion. Although this procedure is considered to be relatively safe, (procedure-related) complications continue to occur. OBJECTIVES: to evaluate procedure-related complications and perinatal loss rates of intrauterine transfusion and changes over time, aiming to identify factors leading to improved outcome...
October 5, 2016: Ultrasound in Obstetrics & Gynecology
Abhinav Arneja, Juan E Salazar, Wenyu Jiang, Jeanne E Hendrickson, James C Zimring, Chance John Luckey
No abstract text is available yet for this article.
August 4, 2016: Haematologica
Dorothea Evers, Jaap Jan Zwaginga, Janneke Tijmensen, Rutger A Middelburg, Masja de Haas, Karen M K de Vooght, Daan van de Kerkhof, Otto Visser, Nathalie C V Péquériaux, Francisca Hudig, Johanna G van der Bom
Red cell alloimmunization may induce severe hemolytic side effects. Identification of risk modifying conditions will help tailor preventative strategies. This study aims to quantify the associations of hematological malignancies and solid cancers with red cell alloimmunization in patients receiving red cell transfusions. We performed a nested multicenter case-control study in a source population of 24,063 patients receiving their first and subsequent red cell transfusions during an eight year follow-up period...
September 15, 2016: Haematologica
Ashish Jain, Ajju Agnihotri, Neelam Marwaha, Ratti Ram Sharma
INTRODUCTION: Red cell allo- and auto-immunization is a well recognized problem in multi-transfused thalassemic patients. We conducted this study on 301 multi-transfused thalassemic patients under the Thalassemia Transfusion Programme of Advanced Pediatric Centre of PGIMER. AIMS AND OBJECTIVES: The study was designed to determine the frequency of alloimmunization and autoimmunization in multi-transfused thalassemic patients and to establish the specificity of alloantibody to red cell antigens, if alloimmunization is detected...
July 2016: Asian Journal of Transfusion Science
Raj Nath Makroo, Soma Agrawal, Aakanksha Bhatia, Mohit Chowdhry, Uday Kumar Thakur
BACKGROUND: Red cell alloimmunization is an acknowledged complication of blood transfusion. Current transfusion practices for thalassemia do not cater to this risk. Serological phenotyping is usually not reliable in these cases unless performed before the first transfusion. Under such circumstances, molecular blood grouping is an effective alternative. AIM: To perform molecular blood group genotyping in chronically transfused thalassemia patients and assess the risk of antigenic exposure and incidence of alloimmunization with current transfusion protocols...
July 2016: Asian Journal of Transfusion Science
Meenu Bajpai, Shruti Gupta, Priyanka Jain
INTRODUCTION: Transfusion support is vital to the management of patients with liver diseases. Repeated transfusions are associated with many risks such as transfusion-transmitted infection, transfusion immunomodulation, and alloimmunization. MATERIALS AND METHODS: A retrospective data analysis of antibody screening and identification was done from February 2012 to February 2014 to determine the frequency and specificity of irregular red-cell antibodies in multitransfused liver disease patients...
July 2016: Asian Journal of Transfusion Science
Huy P Pham, Joseph Schwartz
PURPOSE OF REVIEW: Therapeutic apheresis can be used to treat many diseases. The American Society for Apheresis (ASFA) publishes Guidelines on the use of therapeutic apheresis every 3 years with the goal of providing the best available evidence for apheresis practice as well as clinical expertise. The 2016 (7th ed.) ASFA Guidelines contain 87 diseases (up from 78 in the 6th ed.) and 179 indications. This review outlines three new therapeutic apheresis indications for hematological disorders...
November 2016: Current Opinion in Hematology
Anneke Brand
Most adverse blood transfusion (BT) events are immune-mediated and in the majority of severe reactions antibodies can be identified as causal factors. Alloimmunization not only causes symptomatic reactions, transfused cells can also be (silently) destroyed. Immunization by BT can contribute to hemolytic disease of the newborn as well as to allograft rejection after transplantation. Reversely, pregnancy and transplantation may evoke immunity hampering transfusion therapy. Besides causing mortality and morbidity, alloimmunization has a huge economic impact...
July 2016: La Presse Médicale
Mariela Granero Farias, Suzane Dal Bó, Simone Martins de Castro, Aline Reis da Silva, Joyce Bonazzoni, Luciana Scotti, Sergio H Almeida Martins Costa
Accurate detection and quantitation of fetomaternal hemorrhage (FMH) is critical to the obstetric management of rhesus D alloimmunization in Rh-negative pregnant women. The flow cytometry is based on the detection of fetal red blood cells using a monoclonal anti-HbF antibody, and is the method most indicated for this estimation. The objective of this study was to quantify fetal red blood cell levels of pregnant women using flow cytometry. We analyzed 101 peripheral blood samples from Rh-negative and Rh-positive women, whose mean age was 24 years (20-32 years), after vaginal delivery or cesarean section...
August 5, 2016: Fetal and Pediatric Pathology
Ronald Jackups, William Savage
Adverse consequences of blood transfusion in children are not completely understood. Much remains to be learned about defining their mechanisms, learning how they can be avoided, and improving our understanding how to minimize the morbidity of their consequences. All types of transfusion reactions can occur in children. This article focuses on four adverse consequences that have particular relevance for pediatric populations: cytomegalovirus transmission, red blood cell alloimmunization, immune altering consequences of transfusion, and necrotizing enterocolitis...
October 2016: Transfusion Medicine Reviews
Pimpun Kitpoka, Sarawan Chanthet, Viroje Chongkolwatana, Ampaiwan Chuansumrit, Mongkol Kunakorn
BACKGROUND: The problem of red blood cell (RBC) shortage occurs because of the expanding demand for blood utilization and the dfficulties in donor recruitment and retention. Resources can be maximized by using current technology to collect two units of RBC from the same donor during a single collection session. OBJECTIVE: To evaluate the performance, collection efficiency (CE), production cost, and donor satisfactions of two commercially available blood cell separators (BCS) for double dose red cell (DDRC) collection...
January 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Jeanne E Hendrickson, Stephanie C Eisenbarth, Christopher A Tormey
PURPOSE OF REVIEW: To summarize recent discoveries from clinical studies and animal models that contribute to understanding the alloimmune response to non-ABO blood group antigens. RECENT FINDINGS: Several studies have confirmed high rates of alloimmunization among patients requiring chronic red blood cell (RBC) transfusion. Moreover, 'triggers' for alloantibody development in the transfusion setting have been identified, with a number of investigations linking recipient inflammation to a higher likelihood of alloimmunization...
November 2016: Current Opinion in Hematology
C Dollat, C Pierron, A Keslick, E Billoir, A François, P-H Jarreau
In France since 2002, the single-donor transfusion protocol, using four pediatric units from the same adult donor's packed red blood cells (PRBCs) in multiply transfused newborns, is recommended in preterm neonates to reduce the risks of infection and alloimmunization. This protocol is controversial, however, because it causes the transfusion of stored blood, which could have adverse consequences. Before the new recommendations of the French Haute Autorité de santé (National authority for health) in 2015, we conducted a national practice survey in 63 neonatal intensive care units (NICU) and a retrospective study of the characteristics of 103 children transfused within our unit, to better target beneficiaries...
September 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Y Fichou, M Mariez, C Le Maréchal, C Férec
BACKGROUND: Patients suffering from haemoglobinopathies may be treated by red blood cell (RBC) transfusion on a regular basis and then exposed to multiple antigens with a recurrent, potential risk of alloimmunization routinely prevented by extended RBC antigen cross-matching. While time-consuming and labour-intensive serological analyses are the gold standard for RBC typing, genotyping by current high-throughput molecular tools, including next-generation sequencing (NGS), appears to offer a potent alternative...
July 21, 2016: Vox Sanguinis
Ch Asadov, Z Alimirzoyeva, M Hasanova, T Mammadova, A Shirinova
Research objective is to study the efficacy of recombinant erythropoietin (epoetin alfa) as alternative method of treatment beta-thalassemia intermedia. Study involved 58 patients with beta-thalassemia intermedia (23 women and 35 men). In all observed patients was defined levels of hemoglobin (Hb), red blood cells (RBC), erythrocyte indexes (MCV, MCH, MCHC), hemoglobin fractions (HbA, HbA2, HbF), serum ferritin, serum erythropoietin before and after administrated rEPO. All patients received rEPO during 6 month at the dose - 10000 IU subcutaneously...
June 2016: Georgian Medical News
Meena Sidhu, Renu Bala, Naveen Akhtar, Vijay Sawhney
Screening and detection of clinically significant antibodies among antenatal women plays an important role in transfusion safety and preventing hemolytic disease of fetus and newborn. Routine screening of antenatal women for antibodies is not done in all blood centres of our country and so immunization rates are not known in pregnant women. We studied the prevalence of alloantibodies and titration of Anti D among antenatal multiparous women in Jammu region. In present prospective study, 750 antenatal multiparous women attending antenatal clinics were typed for ABO and D antigens...
September 2016: Indian Journal of Hematology & Blood Transfusion
Giuseppina Perrone, Roberto Brunelli, Eleonora Marcoccia, Ilaria Zannini, Miriam Candelieri, Maria Gozzer, Claudia Stefanutti
Therapeutic apheresis (TA) is a complex extracorporeal procedure for the treatment of several acute and chronic diseases. TA in pregnancy is considered safe for both mother and fetus and has the same indications of non-pregnant patients. TA can be used during the entire course of the pregnancy with the following purposes: (i) to treat several maternal acute and chronic conditions; (ii) to treat fetal conditions; (iii) to avoid administration of drugs potentially harmful to the fetus; and (iv) to reach a more advanced gestational age in order to prevent fetal prematurity...
July 14, 2016: Therapeutic Apheresis and Dialysis
Deepti Sachan, Aswin Kumar, Dinesh Jothimani, Mohamed Rela
Delayed serological transfusion reaction (DSTR) is defined as absence of clinical signs of hemolysis and demonstration of new, clinically-significant antibodies against red blood cells after a transfusion, by either positive direct antiglobulin test or positive antibody screen with newly identified RBC alloantibody. Various delayed hemolytic transfusion reaction cases are reported after red cell transfusions. However, the incidence of DSTR after platelet transfusion due to non-Rh(D) antibodies is not much documented...
June 2016: Indian Journal of Hematology & Blood Transfusion
Asral Wirda Ahmad Asnawi, Jameela Sathar, Rashidah Mohamed, Rohayu Deraman, Sri Kumaran, Shahada Sobah Abd Hamid, Muhd Zanapiah Zakaria
Clinical manifestations of sickle cell disease (SCD) arise from the tendency of the sickle haemoglobin to polymerize and deform red blood cells into the characteristic sickle shape. Sickle cell crisis is a devastating complication that may occur in patients with SCD. If not managed properly permanent organ damage and even death may be the final outcome. A case of a 32-year-old Nigerian lady, Gravida 1 Para 0 in her first trimester, with SCD who developed signs and symptoms of delayed haemolytic transfusion reaction after receiving packed red cell transfusion is demonstrated...
June 2016: Indian Journal of Hematology & Blood Transfusion
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