Asian Journal of Transfusion Science最新文献

Background: Examples of group B red cells that react weakly or not at all with anti-B have been described. Subgroups of B such as B₃, B_x, B_m, and B_el are rare and are less frequently reported. We studied the frequency of subgroups of B in our healthy blood donor population and serologically characterized and differentiated these subgroups.

Materials and methods: The 9-year prospective study included 84,534 healthy blood donors. Initial blood grouping and antibody screening of all donor samples were performed using automated solid-phase assay. Any sample showing blood group discrepancy or weaker agglutination was subjected to further immunohematological investigations.

Results: Among 84,534 healthy donors, "B" blood group was found in 29,190 (34.53%). Weak B phenotypes were demonstrated in 9 (0.031%) B donors. Among the 9 weak B phenotypes, B₃ was the most common followed by B_m. The frequency of B₃, B_m, B_x, and B_el in our blood donor population was found to be 1 in 21,133, 1 in 28,178, 1 in 84,534, and 1 in 84,534, respectively. Red cell agglutination with anti-B and anti-AB varied from Wk+ to 2+ with or without mixed-field agglutination in the B₃ and B_x phenotypes. Naturally occurring anti-B of immunoglobulin M type was detected in the B_x donor. Two (22.2%) of the 9 donors were found to be nonsecretor. Adsorption-elution demonstrated "B" antigen specificity in different strengths in B_m, B_x, and B_el phenotypes.

Conclusion: We conclude that differentiating weak subgroups of "B" by serological assays is possible to a great extent with technical expertise. Mistyping weak subgroups of B as "O" group may lead to reporting errors and wrong blood transfusion. Therefore, blood centers in developing countries including India should establish simple techniques to detect and differentiate weak subgroups and develop procedures to ensure safe blood transfusion and transplantation.

Karl Landsteiner discovered ABO blood group system in the early 20^th century, but still, uncertainty remains in immunohematology while detection of ABO subgroups or weaker variants. The presence of weak subgroups in patient samples gives rise to the discrepancy in forward (cell) and reverse (serum) grouping. We here report a case of the B(A) phenotype in a patient who was diagnosed with chronic liver disease with acute pancreatitis, requiring packed red blood cells due to anemia. The blood group discrepancy was resolved using serological testing and adsorption-elution technique. Blood grouping by the tube technique showed 2+ agglutination with anti-A antisera, strong agglutination (4+) with anti-B, anti-AB, and anti-D antisera, 4+ agglutination with A1 cells, and no agglutination with B cells and O cells in serum grouping. Results for both eluate and last wash were negative to all the donor cells used. This report highlights the importance of cell and serum grouping, solving blood group discrepancy, and also in providing crossmatch compatible blood components without delay. This rare phenotype in a patient is the first of its kind reported from India.

Background: Transfusion support is vital for the management of patients with hepatobiliary disease. Repeated blood transfusions increase the risk of alloimmunization, i.e., the development of alloantibodies, which might lead to difficulties in blood crossmatching.

Aims: This study aims to: (1) determine the incidence of red blood cell (RBC) alloimmunization and (2) evaluate the associations between antibody development and demographic factors among hepatobiliary patients.

Method: ABO blood grouping, antibody screening, antibody identification and crossmatch were done on all patients samples included in the study.

Settings and design: A cross-sectional study was conducted from February 2021 to September 2021, with a total of 132 samples from hepatobiliary patients. The relationships between RBC alloimmunization in transfused hepatobiliary patients and demographic factors (gender, age, and history of transfusion) were assessed by binary logistic regression.

Results: Overall, 67.4% of the patients developed alloimmunization. The majority had a single alloantibody (75.2%) and the most frequently identified antibody specificities were anti-E (37.6%), anti-c (12.8%), anti-Mia (14.4%), and anti-Kidd (11.2%). The predominant antibodies were those against the Rh system (58.4%). Female patients recorded the highest incidence of alloimmunization (69.8%). Female patients also demonstrated a higher tendency to produce both anti-E + anti-c than male patients.

Conclusion: The prevalence of RBC alloimmunization is high among hepatobiliary patients and it may cause complications requiring multiple transfusions. The number of transfused packed cells has been clearly shown to be proportionally significant with the risk for alloimmunization in hepatobiliary patients. Hence, this study highlights the importance of immunohematology tests before blood transfusion.

Introduction: Platelet collection by apheresis is common nowadays. Many cell separators are available in the market for the same. This study was conducted to study the effect of various donor factors on platelet yield and the effect of different cell separator variables on platelet yield.

Materials and methods: This cross-sectional study was done on 600 healthy apheresis platelet donors from April 2016 to March 2017 using three different cell separators. Donor variables, pre, and post-plateletpheresis hematological parameters, machine variables, platelet yield were observed.

Results: Postprocedural decline in hematological variables was seen. A positive correlation was seen with pre-apheresis platelet count, blood volume processed, and product volume. Product volume obtained was highest with COM. TEC. Mean platelet yield was maximally seen in Amicus.

Conclusion: Main predictors of platelet yield are platelet count and volume processed. Donors with lower hemoglobin had better yields. Higher platelet counts lead to better product hence platelet increment in the patient.

A end is a weak subgroup of Blood group A, found rarely in general population, not detected by routine forward and reverse blood grouping, detected by Adsorption/Elution technique along with saliva testing for A, B and H antigens. Although it is subgroup of A but it lacks A antigen in saliva and contains only H antigen. A 25y/M was accepted for blood donation and showed weak/mf reaction with anti-A in forward grouping. On Adsorption/Elution testing eluate gave 2+ reaction with known A1 cells, and Saliva testing showed presence of only H substance. A weak A can be mistyped as O & can lead to a Hemolytic transfusion reaction so anti-H, anti-A1 & anti-AB should be incorporated in forward grouping and every O group sample should be treated with anti-AB antisera.

Hemolytic disease of foetus and newborn (HDFN) is a disease characterized by the destruction of fetal red cells by the maternal antibodies which occurs due to allo immunization in the mother by feto-maternal blood group incompatibility. The antibodies most frequently implicated in HDFN may vary depending on the demographic location under consideration. In areas where RhIg administration is available, ABO antibodies are more commonly implicated. Following ABO antibodies, anti-RhD antibodies which are of IgG type are more commonly implicated in causing HDFN. HDFN caused by other Rh system antibodies namely anti-C, anti-c, anti-E, anti- e, MNS, KEL, FY, JK, and DI systems is less frequent. We have reported one such rare case of Hemolytic disease of fetus and newborn due to Anti--S. During the routine antenatal screening for irregular antibodies, using antibody identification cell panel BIO-RAD (ID Diapanel 11x4) which belongs to lot number (06171.47.x - 06271.47.x), anti-S was identified in the mother serum. The baby was non-hydropic at birth with an increase in bilirubin which required high-intensity phototherapy.

Drug-induced hemolytic anemia (DIHA) is a rare but significant condition characterized by the premature destruction of red blood cells (RBCs) triggered by certain medications. Ceftriaxone, a commonly used antibiotic, has been linked to DIHA, presenting diagnostic challenges due to its diverse clinical manifestations. This study examines three cases of DIHA caused by ceftriaxone therapy at our center. The patients presented with symptoms such as fatigue, jaundice, and dark urine following ceftriaxone therapy. Laboratory tests indicated hemolytic anemia with decreased hemoglobin, elevated lactate dehydrogenase, and positive direct antiglobulin tests. Immunohematological workups confirmed ceftriaxone-induced antibodies targeting RBCs and guided management strategies, including discontinuation of ceftriaxone, supportive therapy, and corticosteroids. Timely diagnosis and collaboration between clinicians and laboratory specialists are crucial for optimal patient outcomes.

Background: The direct antiglobulin test (DAT) detects red blood cell (RBC) sensitivity to complement or IgG in vivo. The clinical disorders of hemolytic disease of the newborn, hemolytic transfusion reaction, and autoimmune and drug-induced hemolytic anemia are some examples of those that can cause in vivo coating of RBCs with antibodies or complement autoimmune hemolytic anemia (AIHA). Rarely, DAT is positive in nonimmune-mediated hemolytic anemias as well. Standard donor screening techniques do not require the DAT to be performed.

Aims and objectives: The aim of the study was to assess the prevalence of DAT positive in healthy blood donors at a tertiary blood center in North India.

Materials and methods: This 2-year prospective observational study included whole blood donors from January 2020 to December 2022. A total of 152,564 healthy blood donors including 150,246 (98.5%) males and 2318 (1.5%) females were donated at the department of transfusion medicine.

Results: Of a total of 152,564 donors, 150,246 (98.5%) were male, and 2,318 (1.5%) were female. Among the male donors, 11 (0.007%) had a history of blood transfusion and 16 (0.011%) tested DAT positive. Among the female donors, 15 (0.647%) had a history of blood transfusion and none of them tested DAT positive.

Conclusion: We observed low levels of DAT positivity in healthy blood donors. Such donors should be regularly monitored to check for any long-term development of malignancies or clinical or laboratory indications of hemolysis. DAT-positive blood units do not supply the recipient at risk, which may cause negative consequences.