Prevalence of Red Cell Alloantibodies among Multi Transfused Egyptian Patients

Document Type : Original Article

Authors

1 Internal medicine hematology department faculty of medicine Alexandria University

2 Shatby blood bank Alexandria University.

3 Department of Internal Medicine and Hematology, Faculty of Medicine, Alexandria University-Egypt

Abstract

Introduction
Blood Transfusion-dependency doesn’t come without its serious hazards. RBCs Alloimmunization in multi-transfused is a major challenge. Alloimmunization is a late complication that affects 8% to 12% of recipients. This percentage increases if patients on continuing transfusion regimens, such as those with sickle cell anemia, thalassemia and chronic renal failure. The immune-mediated damage of circulating (RBCs) can happen by two mechanisms: the first is intravascular destruction by complement lysis of the IgM class.The second one is extravascular destruction by immune cells which recognize IgG and complement bound to RBC. Frequency, risk factors, and specificities of alloantibodies were our goals in this study, which was conducted on patients in Alexandria governorate, Egypt, with the goal of reducing the transfusion-related risks.
MATERIALS AND METHODS: A total of 400 patients with thalassemia, sickle cell and chronic renal failure attending Alexandria university hospital were evaluated. Alloantibody screening and documentation was accomplished by the DiaMed-ID micro-typing system.
Results: prevalence of alloimmunization was 3.8% (15 of 400). The most shared alloantibody was RhD-related; anti-E was the recurrent alloantibody seen in five of the 15 patients (33.3%), followed by anti-D in four patients (26.7%), anti-kell in two (13.3%), anti-c, anti-C, Anti-Fya and Anti-Jka each in one patient (6.7%)
Conclusion: High alloimmunization rates were found in male patients, in patients with chronic renal failure (13.6%) followed by sickle cell anemia (13.3%) then thalassemia (2.8%). A statistically significant relation between splenectomy, age at starting blood transfusion and use of leukoreduced blood was detected (P < 0.05).

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