Asian Journal of Transfusion Science最新文献

Para-Bombay blood group is a rare blood group typically characterized by the absence of H antigens on red blood cell and the presence of ABH substances on secretion. It can be easily missed and often mistaken as blood group O without extended testing. Detection is important as it significantly affect transfusion management. We report two cases of Para-Bombay A blood group in a teaching hospital in a North-Eastern state of Malaysia.

Red cell exchange is important to treat acutely ill sickle cell patients, but it is time-consuming. An automated red cell exchange technique using cell separators developed by different manufacturers helps in removal of sickled hemoglobin and improving blood viscosity. The use of these cell separators permits automated red cell exchange to be performed safely and smoothly with the isovolemic hemodilution. The retrospective analysis of seven cases for automated red cell exchange was performed in IMS and SUM Hospital from September, 2019 to July 2021. One procedure was performed on COBE Spectra Apheresis System and the rest six using Spectra Optia Apheresis System. These procedures were performed on the patients and the decision to perform these procedures was based on clinical indications for red cell exchange following the ASFA guidelines 2019. After only one procedure, all the patients have their sickle hemoglobin reduced to a safe level. End hematocrit was observed to be 33% in three cases, 31.9% in one case, and 30% in the rest three. A total number of red blood cells (RBCs) transfusion in all the cases were 7, 6, 8, 5, 6, 7, and 7 with an average hematocrit of 55%, 56%, 54%, 56%, 55%, 51.7%, and 52.2%, respectively. All the patients partially phenotypically matched, leukoreduced, gamma-irradiated, fresh packed RBCs were provided. Automated red cell exchange came out to be successful in reducing the symptoms along with the improvement in laboratory parameters. New-generation automated apheresis equipment like Spectra Optia, the case series provides better monitoring and also reduces apheresis-related complications.

Background: High titers of anti-A and anti-B are considered to be one reason for hemolytic transfusion reactions and ABO hemolytic disease in fetus and neonates. There is no consensus for critical ABO antibody titers to guide transfusion or transplant decisions. Implementation of ABO titer measurement can favor reduction in transfusion reactions in nongroup "O" recipients.

Aims: This study aimed to understand the trend and quantification of anti-A and anti-B antibody titers in Group "O" donors in this geography.

Subjects and methods: A prospective study was conducted in 218, Group "O" blood donors in the year 2021, during the COVID-19 pandemic. Immunoglobulin (Ig) M antibody titers were measured by hemagglutination and IgG titers by solid-phase red cell adherence. Antibody titers ≥128 for IgG and ≥64 for IgM were considered "high titers." Epi Info 7.1 software was used for statistical analysis, with P < 0.05 significant.

Results: About 96.75% of blood donors were male with a median age of 33.16 ± 8.8 years. ABO antibody titers ranged from 0 to 1024. The prevalence of titers of <128 for IgG anti-A and anti-B was 79.36% and 86.24%, respectively, and 88.53% for both anti-A and anti-B IgM (<64). High IgG anti-A antibody titers were exhibited in 20.64% and anti-B titers in 13.76% of donors. None of the recipients showed any hemolytic reactions.

Conclusions: The donor population showed predominance of low isoagglutinin titers. Defining critical titers will help formulate institutional guidelines on ABO-incompatible platelet transfusions and transplants. The use of automation in ABO titer assays removes interobserver variations and offers precise, reproducible, and less labor-intensive assays in resource-constrained settings.

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.

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.

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.

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.