Red cell alloimmunization in chronic kidney disease patients

Author: 
Shantipriya Bhardwaj, Vinod Agarwal, Dev Raj Arya, N.L. Mahawar, Arun Bharti, Shailendra Vashistha, Ravindra Yadav, Kunal Purohit, Sonam and Kaluram Meghwal

Background: There is a high incidence of alloimunization in many patients with diseases that require repetitive blood transfusions. One such group is chronic renal failure patients as majority of them have severe anemia due to deficiency of erythropoietin. As many such patients are unable to afford erythropoietin, they are treated with blood transfusions. This study was thus undertaken to study alloimunization in such patients at our center.
Methods: A total of 155 patients found eligible were enrolled in this cross-sectional study that was carried out from April 2018 to November 2018. After detailed history, antibody screening was done by using a commercial two cell panel of the SPRCAT (Capture, Immunor Inc. Norcross, GA). All cases where antibody screen test was positive were subjected to antibody identification. These positive samples were investigated to identify thedetected antibodies using commercial 16 cell panel of SPRCAas and when required.
Results: 155 patients including 82 male and 73 female patients. Alloantibodies were detected in a total of 2 patients (1.29%). Both the patients having multiple antibodies.On alloantibody type identification, the most common type found was anti C and Duffy B (2/4) each. Prevalence of alloimmunization in both the sex is about 50-50 %
Conclusions: Alloimmunization to minor erythrocyte antigens occurs in many patients of chronic kidney disease patients. This results in frequent pre-and post-transfusion complications. Inclusion of antibody screening test in routine pretransfusion testing protocol for the patients who are at higher risk of alloimmunization and require long-term transfusion dependence is desirable.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2019.17681.3361
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