Selection of GP. Mur antigen-negative RBC for blood recipients with anti-'Mi(a) ' records decreases transfusion reaction rates in Taiwan.

OBJECTIVES: To evaluate the clinical significance of GP. Mur antigen-negative blood selection for transfusion in patients with anti-'Mi(a) ' records.

BACKGROUND: The GP. Mur RBC phenotype is prevalent (7·3%) in Taiwan. Antibodies against GP. Mur (anti-'Mi(a) ') are identified in 1·24% of our population, and anti-'Mi(a) ' screening using GP. Mur RBC has been routine for Taiwan's blood banks. However, due to the lack of commercial antibodies, only cross-matching was used to prevent transfusion of GP. Mur-positive blood to patients with anti-'Mi(a) ' in most hospitals. There is still a risk of GP. Mur-positive RBC exposure and subsequent anti-'Mi(a) '-related transfusion reactions.

METHODS: Since February 2014, GP. Mur antigen-negative RBCs identified by reaction with anti-'Mi(a) '-positive serum were selected for blood recipients with anti-'Mi(a) ' records. The transfusion reactions between January 2013 and January 2014 were compared with those that occurred between February 2014 and July 2015.

RESULTS: The transfusion reaction rate was significantly higher in anti-'Mi(a) '-positive blood recipients compared to total subjects receiving an RBC transfusion before GP. Mur-negative donor RBC selection. After antigen-negative RBC selection, the transfusion reaction frequency in subjects with anti-'Mi(a) ' became similar to total blood recipients. IgG form anti-'Mi(a) ' antibodies were present in all cases of probable anti-'Mi(a) '-related transfusion reactions. The time required for anti-'Mi(a) ' boosting after transfusion was around 4-21 days.

CONCLUSION: Selection of GP. Mur-negative RBC for transfusion to patients with anti-'Mi(a) ' records could decrease the rate of transfusion reaction and antibody boosting. This procedure should be incorporated into blood bank routines in areas where anti-'Mi(a) ' is prevalent.