2,398 results match your criteria Alloimmunization From Transfusions


Susceptible and protective HLA-DR and HLA-DQ alleles for Fy alloimmunization in the Croatian population.

Transfusion 2018 Dec 12. Epub 2018 Dec 12.

Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Center Zagreb, Zagreb, Croatia.

Background: Alloimmunization is a known risk of transfusion therapy caused by exposure to foreign RBC antigens. However, alloimmunization is not observed in all transfused patients. Human leukocyte antigen (HLA) molecules may contribute to the recognition and presentation of foreign antigens and to the potency of immune responses that result in the production of antibodies. Read More

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December 2018

Marginal Zone B Cells Induce Alloantibody Formation Following RBC Transfusion.

Front Immunol 2018 16;9:2516. Epub 2018 Nov 16.

Department of Laboratory Medicine and Pathology, Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, GA, United States.

Red blood cell (RBC) alloimmunization represents a significant immunological challenge for some patients. While a variety of immune constituents likely contribute to the initiation and orchestration of alloantibodies to RBC antigens, identification of key immune factors that initiate alloantibody formation may aid in the development of a therapeutic modality to minimize or prevent this process. To define the immune factors that may be important in driving alloimmunization to an RBC antigen, we determined the specific immune compartment and distinct cells that may initially engage transfused RBCs and facilitate subsequent alloimmunization. Read More

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November 2018
2 Reads

Shifting ground and gaps in transfusion support of patients with hematological malignancies.

Hematology Am Soc Hematol Educ Program 2018 Nov;2018(1):553-560

Laboratory Medicine and Pathobiology (Transfusion Medicine) and Medicine (Clinical Hematology), University Health Network/University of Toronto, Toronto, ON, Canada.

The transfusion support of hematological malignancies considers 2 dimensions: the quantity of what we order (in terms of triggers, doses, targets, and intervals), and the special qualities thereof (with respect to depths of matching and appropriate product modifications). Meanwhile, transfusion-related enhancements in the quantity and quality of life may not be dose dependent but rather tempered by unintended patient harms and system strains from overexposure. Evidence and guidelines concur in endorsing clinically noninferior conservative red blood cell (RBC) transfusion care strategies (eg, triggering at hemoglobin <7-8 g/dL and in single-unit doses for stable, nonbleeding inpatients). Read More

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November 2018
1 Read

Red Blood Cell Alloimmunization in Multitransfused Pediatric Population in a Tertiary Care Hospital.

Indian J Pediatr 2018 Dec 4. Epub 2018 Dec 4.

Department of Pediatrics, Government Medical College, Thiruvananthapuram, Kerala, India.

Objectives: To estimate the prevalence and specificity pattern of red blood cell (RBC) alloimmunization among pediatric multitransfused patients, and to identify the factors associated with alloimmunization.

Methods: This was a descriptive cross-sectional study conducted among mutitransfused pediatric patients over a period of two years. The relevant clinical details of patients were collected, and RBC antibody screening was done. Read More

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December 2018
1 Read

The role of pathogen-reduced platelet transfusions on HLA alloimmunization in hemato-oncological patients.

Transfusion 2018 Nov 30. Epub 2018 Nov 30.

Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands.

Background: Platelet transfusions can induce alloimmunization against HLA antigens. The use of pathogen-reduced platelet concentrates (PCs) was suggested to reduce HLA alloimmunization and concomitant transfusion refractoriness.

Methods: This study investigated HLA alloimmunization in available samples from 448 hemato-oncological patients who were randomized for the Pathogen Reduction Evaluation and Predictive Analytical Rating Score (PREPAReS) trial to receive either untreated or pathogen-reduced PCs (Mirasol, Terumo BCT Inc. Read More

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November 2018
1 Read

Molecular Genetics of the Human Neutrophil Antigens.

Transfus Med Hemother 2018 Oct 17;45(5):300-309. Epub 2018 Aug 17.

Laboratory for Immunogenetics /HLA, DRK Blutspendedienst West, Bad Kreuznach, Germany.

Background And Objective: Antibodies to human neutrophil antigens (HNAs) have been implicated in transfusion-related acute lung injury and allo- and autoimmune neutropenia. To date, five HNA systems are assigned, and during the last decades enormous efforts have been undertaken to identify the underlying genes and to characterize the antigens. This review of the literature will provide the current genetic, molecular and functional information on HNAs. Read More

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October 2018
3 Reads

Multiplex blood group typing by cellular surface plasmon resonance imaging.

Transfusion 2018 Nov 29. Epub 2018 Nov 29.

Department of Experimental Immunohematology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Background: Blood-group typing of donors and patients is essential to avoid incompatible transfusions. Transfusion of incompatible RBCs may result in alloimmunization complicating future transfusions or in the presence of antibodies in adverse reactions. With more than 300 blood group antigens identified, it is difficult to provide fully compatible blood. Read More

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November 2018
2 Reads

Prevalence and clinical significances of red cell alloimmunization and red cell bound immunoglobulin G in polytransfused patients with thalassemias.

Hematology 2019 Dec;24(1):208-214

a Division of Hematology, Department of Medicine, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.

The study was to determine the prevalence and clinical significances of red blood cell (RBC)-bound IgG as detected by flow cytometry in polytransfused patients with thalassemias. Relationship of the presence of RBC-bound IgG with RBC alloimmunization was also evaluated. This study included 59 polytransfused patients with β-thalassemia disease. Read More

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December 2019
1 Read

The prevalence, alloimmunization risk factors, antigenic exposure, and evaluation of antigen-matched red blood cells for thalassemia transfusions: a 10-year experience at a tertiary care hospital.

Transfusion 2018 Nov 15. Epub 2018 Nov 15.

Blood Transfusion Center, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Background: Hemoglobin E-β thalassemia and homozygous β -thalassemia are the most common chronic transfusion-dependent thalassemias in Thailand. Patients with these conditions can experience clinical complications such as RBC alloimmunization. In this study we aimed to determine the prevalence, alloimmunization risk factors, antigenic exposure, and evaluation of antigen- (C, c, E, e, Mi ) matched RBC transfusion. Read More

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November 2018
8 Reads

Red Blood Cell Alloimmunization in Korean Patients With Myelodysplastic Syndrome and Liver Cirrhosis.

Ann Lab Med 2019 Mar;39(2):218-222

Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Red blood cell (RBC) alloimmunization varies across human populations and ethnic groups. We evaluated the characteristics of RBC alloimmunization and compared the risk of alloimmunization in Korean patients with myelodysplastic syndrome (MDS) and liver cirrhosis (LC), two representative diseases in which chronic transfusion is required. In total, 115 MDS patients and 202 LC patients transfused with RBCs between 2013 and 2015 were retrospectively included. Read More

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March 2019
4 Reads

Complement serves as a switch between CD4+ T cell-independent and -dependent RBC antibody responses.

JCI Insight 2018 Nov 15;3(22). Epub 2018 Nov 15.

Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology.

RBC alloimmunization represents a significant immunological challenge for patients requiring lifelong transfusion support. The majority of clinically relevant non-ABO(H) blood group antigens have been thought to drive antibody formation through T cell-dependent immune pathways. Thus, we initially sought to define the role of CD4+ T cells in formation of alloantibodies to KEL, one of the leading causes of hemolytic transfusion reactions. Read More

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November 2018
1 Read

Prevalence and risk factors for RBC alloantibodies in blood donors in the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III).

Transfusion 2018 Nov 14. Epub 2018 Nov 14.

Department of Laboratory Medicine, Yale University, New Haven, Connecticut.

Background: Little information exists on red blood cell (RBC) alloimmunization in healthy US blood donors, despite the potential significance for donors themselves, blood recipients, and the blood center.

Study Design And Methods: Donor/donation data were sourced from the Recipient Epidemiology and Donor Evaluation Study-III, which contains information from four US blood centers during 2012 through 2016. Multivariable logistic regression was used to assess prevalence of positive antibody screen by donor demographics, blood type, parity, and transfusion history. Read More

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November 2018
7 Reads

Mild Allergic Transfusion Reactions: Impact of Associated Clinical Symptoms?

Am J Clin Pathol 2018 Nov 13. Epub 2018 Nov 13.

Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN.

Objectives: Transfusions are often needlessly aborted after occurrence of a mild allergic transfusion reaction (ATR), leading to wastage and reexposure of recipients to additional blood products (with potential alloimmunization). We aimed to determine the symptoms associated with such reactions (along with other parameters) as a possible reason of concern for transfusionists aborting such transfusions.

Methods: We reviewed the symptomology of all mild ATRs (as well as the associated wastage and costs of aborted transfusions) at an academic medical center that occurred over a period of 1 year. Read More

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November 2018
4 Reads

Phenotyping of Rh, Kell, Duffy and Kidd Blood Group Antigens among Non-Tribal and Tribal Population of South Gujarat and its Implication in Preventing Alloimmunization in Multitransfused Patients.

Mediterr J Hematol Infect Dis 2018 1;10(1):e2018070. Epub 2018 Nov 1.

Surat Raktadan Kendra & Research Centre, Udhna Magdalla Road (Nr. Chosath Joganio Mata Mandir), Surat 395002, Gujrat India.

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November 2018
4 Reads

Maternal HLA-G*01:01:01:04 protects from anti-HLA-class II immunization in pregnant women.

Hum Immunol 2018 Nov 7. Epub 2018 Nov 7.

Aix Marseille Univ, CNRS, EFS, ADES, "Biologie des Groupes Sanguins", Marseille, France; Etablissement Français du Sang PACA Corse, Marseille, France. Electronic address:

Factors determining anti-HLA immunization are poorly understood, although anti-HLA immunization following pregnancy is well described. The HLA-G molecule has been extensively described for its implication in immunological tolerance, especially during pregnancy. Transplant studies show an association between HLA-G haplotypes and alloimmunization. Read More

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November 2018
4 Reads

Antibody-mediated immune suppression by antigen modulation is antigen-specific.

Blood Adv 2018 Nov;2(21):2986-3000

Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA; and.

Alloantibodies developing after exposure to red blood cell (RBC) alloantigens can complicate pregnancy and transfusion therapy. The only method currently available to actively inhibit RBC alloantibody formation is administration of antigen-specific antibodies, a phenomenon termed antibody-mediated immune suppression (AMIS). A well-known example of AMIS is RhD immune globulin prophylaxis to prevent anti-D formation in RhD individuals. Read More

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November 2018
10 Reads

Nonimmune hydrops fetalis: identifying the underlying genetic etiology.

Genet Med 2018 Nov 9. Epub 2018 Nov 9.

Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco, CA, USA.

Purpose: Numerous etiologies may lead to nonimmune hydrops fetalis (NIHF), and the underlying cause often remains unclear. We aimed to determine the proportion of NIHF cases in which the etiology was clearly determined in a large, contemporary, and diverse cohort, as well as to describe the etiologies with a focus on genetic causes.

Methods: Retrospective review of NIHF cases between 2015 and 2017 from the five University of California Fetal-Maternal Consortium sites. Read More

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November 2018
1 Read

How we evaluate red blood cell compatibility and transfusion support for patients with sickle cell disease undergoing hematopoietic progenitor cell transplantation.

Transfusion 2018 Nov 28;58(11):2483-2489. Epub 2018 Sep 28.

Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland.

Multiple hematopoietic progenitor cell (HPC) transplantation options for patients with sickle cell disease (SCD) are currently under investigation. Patients with SCD have a high rate of alloimmunization to red blood cell antigens, often complicating transfusion support. Transfusion reactions, including acute and delayed hemolytic reactions, have been observed despite immunosuppressive regimens. Read More

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November 2018
7 Reads

Red blood cell alloimmunization among hospitalized patients: transfusion reactions and low alloantibody identification rate.

Hematol Transfus Cell Ther 2018 Oct-Dec;40(4):326-331. Epub 2018 May 22.

Hospital das Clinicas da Universidade Federal de Goiás (HC/UFG), Goiânia, GO, Brazil.

Background: Unexpected red blood cell alloantibodies can cause hemolytic transfusion reactions. In this study, the prevalence of alloimmunization, the rate of identification of alloantibodies and the rate of blood transfusion reactions among transfused patients were identified in a clinical emergency hospital in Brazil.

Methods: Transfusions and clinical records of patients who had a positive indirect antiglobulin test between January and December 2013 were analyzed. Read More

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May 2018
1 Read

Low IL-2 Expressing T Cells in Thalassemia Major Patients: Is It Immune Aging.

Indian J Hematol Blood Transfus 2018 Oct 7;34(4):653-661. Epub 2018 Mar 7.

4Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.

Several studies have demonstrated T cell alteration and some features of immunosenescence in thalassemia major. Repeated alloimmunization converts naïve T-cells to memory cells and iron overload causes oxidative stress accelerating immune aging. To determine whether the alteration of T-cell cytokine is matched with early immune aging, the quantity of cytokine expressing T cells and their correlation to some immune aging markers were investigated. Read More

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October 2018
5 Reads

The Role of the Immunological Synapse in Differential Effects of APC Subsets in Alloimmunization to Fresh, Non-stored RBCs.

Front Immunol 2018 5;9:2200. Epub 2018 Oct 5.

Bloodworks Northwest Research Institute, Seattle, WA, United States.

Each year, over 5 million red blood cell (RBC) transfusions are administered to patients in the USA. Despite the therapeutic benefits of RBC transfusions, there are associated risks. RBC-specific alloantibodies may form in response to antigenic differences between RBC donors and recipients; these alloantibodies can be a problem as they may mediate hemolysis or pose barriers to future transfusion support. Read More

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October 2018
1 Read

IgG-mediated immune suppression in mice is epitope specific except during high epitope density conditions.

Sci Rep 2018 Oct 16;8(1):15292. Epub 2018 Oct 16.

Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.

Specific IgG antibodies, passively administered together with erythrocytes, suppress antibody responses against the erythrocytes. Although used to prevent alloimmunization in Rhesus (Rh)D-negative women carrying RhD-positive fetuses, the mechanism behind is not understood. In mice, IgG suppresses efficiently in the absence of Fcγ-receptors and complement, suggesting an Fc-independent mechanism. Read More

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October 2018
3 Reads

Fetal anemia.

Minerva Ginecol 2018 Oct 11. Epub 2018 Oct 11.

Department of Obstetrics and Gynecology, Health Sciences Center, University of Tennessee, Memphis, TN, USA.

The diagnosis and management of fetal anemia has been at the forefront of advances in the fields of fetal physiology, immunology, fetal imaging, and fetal therapy among others. Alloimmunization and parvovirus infection are the leading cause of fetal anemia in the United States. The middle cerebral artery peak systolic velocity (MCA-PSV)diagnoses fetal anemia. Read More

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October 2018
1 Read

Alloimmunization risk associated with amino acid 223 substitution in the RhD protein: analysis in the light of molecular modeling.

Transfusion 2018 Nov 4;58(11):2683-2692. Epub 2018 Oct 4.

Laboratory of Excellence GR-Ex, Paris.

Background: Partial D status is a major concern for transfusion and pregnancy, due to the possibility of carriers becoming immunized. When known carriers of a D variant have never been exposed to complete D, they are assumed to have D partial status based on the position of the amino acid substituted. New approaches for predicting immunization risk are required. Read More

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November 2018
7 Reads

Delayed Cord Clamping Increased the Need for Phototherapy Treatment in Infants With AB0 Alloimmunization Born by Cesarean Section: A Retrospective Study.

Front Pediatr 2018 19;6:241. Epub 2018 Sep 19.

Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.

To compare the effect of Delayed Cord Clamping (DCC) to Immediate Cord Clamping (ICC) on phototherapy treatment in a cohort of cesarean-delivered newborns with AB0-alloimmunization. In a retrospective cohort study neonates with Gestational Age (GA) ≥ 35 weeks and diagnosed with AB0-alloimmunization before implementation of DCC (ICC group) were compared with neonates born after implementation (DCC group). The primary outcome was the need for phototherapy. Read More

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September 2018
1 Read

Transfusion Support of Minority Patients: Extended Antigen Donor Typing and Recruitment of Minority Blood Donors.

Transfus Med Hemother 2018 Jul 19;45(4):271-276. Epub 2018 Jul 19.

Pathology & Laboratory Medicine Division, Children's National Health System, Washington, DC, USA.

One of the most important and persistent complications of blood transfusion is red blood cell (RBC) alloimmunization. When a patient is exposed to RBC antigens that differ from their own they can form alloantibodies to these foreign antigens. Blood group antigens are highly conserved and follow ancestral patterns of inheritance that may demonstrate population restriction. Read More

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July 2018
1 Read

Optimized Antigen-Matched in Sickle Cell Disease Patients: Chances and Challenges in Molecular Times - the Brazilian Way.

Transfus Med Hemother 2018 Jul 6;45(4):258-262. Epub 2018 Jul 6.

Fundação Pró-Sangue, Hemocentro de São Paulo, São Paulo, Brazil.

The development of red blood cell (RBC) alloantibodies and autoantibodies complicates transfusion therapy in sickle cell disease (SCD) patients. In an effort to reduce the risk of alloimmunization, some strategies have been used to provide antigen-matched RBC transfusions to patients with SCD in Brazil, including molecular matching in 3 levels: RH and K matching; extended matching (RH, KEL, FY, JK, MNS, DI), and extended matching including and variant alleles. Molecular matching has shown clinical benefits to the patients with SCD, contributing significantly to reduce the rates of alloimmunization. Read More

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July 2018
2 Reads

Rh-Matched Transfusion through Molecular Typing for β-Thalassemia Patients Is Required and Feasible in Chinese.

Transfus Med Hemother 2018 Jul 5;45(4):252-257. Epub 2018 Jul 5.

Department of Blood Transfusion, The First Affiliated Hospital of Shenzhen University School of Medicine, The Second People's Hospital of Shenzhen, Shenzhen, China.

Background: Molecular typing for blood group alleles has been established in many countries for patients and blood donors. In the Chinese literature nearly 80% of transfused patients with alloimmunization have antibodies specific for antigens of the Rh blood group system. We investigated if it is feasible to match packed red blood cells (RBCs) for Chinese β-thalassemia patients by genotyping. Read More

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July 2018
7 Reads

Intraoperative Cell Salvage During Transurethral Resection of Prostate: A Case Report.

A A Pract 2018 Sep 28. Epub 2018 Sep 28.

Department of Urology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Intraoperative cell salvage (ICS) became commercially available in 1968 and has enjoyed wide uptake. However, its use in transurethral resection of prostate (TURP) remains rare. We describe a 71-year-old man who underwent TURP with incomplete blood cross-matching. Read More

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September 2018
2 Reads

Anti-D from alloimmunization versus RhIG: detective work in the blood bank and transfusion medicine services.

Transfusion 2018 Nov 19;58(11):2490-2494. Epub 2018 Sep 19.

Department of Pathology, University of Virginia Health System, Charlottesville, Virginia.

Background: The blood bank and transfusion medicine services (BBTMS) engages with electronic health records (EHRs), clinicians, and outside hospitals (OHs) to obtain comprehensive patient history to optimize care. Detection of anti-D in a pregnant patient underscores this work. Differentiating passive anti-D due to RhIG administration versus alloanti-D affects clinical decision making. Read More

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November 2018
3 Reads

Exposure to non-inherited maternal antigens by breastfeeding affects antibody responsiveness.

Haematologica 2018 Sep 13. Epub 2018 Sep 13.

Center for Clinical Transfusion Research, Sanquin Research, Leiden, Netherlands.

The observation, by Ray Owen and colleagues in 1954, that D-negative women were less likely to form anti-D antibodies against their D-positive fetus if their mother possessed the D-antigen, was not found in all later studies. We hypothesized that breastfeeding, received by the mother, may affect her immunity against non-inherited maternal red blood cell antigens. We studied a cohort of 125 grandmother-mother-child combinations, from a follow-up study of mothers after intrauterine transfusion of the fetus for alloimmune hemolytic disease. Read More

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September 2018
13 Reads

The near disappearance of fetal hydrops in relation to current state-of-the-art management of red cell alloimmunization.

Prenat Diagn 2018 Nov 27;38(12):943-950. Epub 2018 Sep 27.

Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.

Objective: In this study, we aim to evaluate trends in the condition of fetuses and neonates with hemolytic disease at the time of first intrauterine transfusion (IUT) and at birth, in relation to routine first-trimester antibody screening, referral guidelines, and centralization of fetal therapy.

Method: We conducted a 30-year cohort study including all women and fetuses treated with IUT for red cell alloimmunization at the Dutch national referral center for fetal therapy.

Results: Six hundred forty-five fetuses received 1852 transfusions between 1 January 1987 and 31 December 2016. Read More

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November 2018
8 Reads

Major Issues of Care in Thalassemia Major Children Refugees.

J Pediatr Hematol Oncol 2018 Aug 31. Epub 2018 Aug 31.

Departments of Pediatrics.

Beta thalassemia major (βTM) is the most common inherited hemoglobinopathy. Management essentially focuses on preventing and treating complications. Conventional treatment is based on a regular blood transfusion program, and chelation therapy. Read More

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August 2018
3 Reads

Revisiting the use of intravenous immune globulin (IVIG) for Kell alloimmunization.

Authors:
James R Scott

Am J Obstet Gynecol 2018 Sep;219(3):223-224

Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA. Electronic address:

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September 2018
1 Read

Identification and follow-up of pregnant women with platelet-type human platelet antigen (HPA)-1bb alloimmunized with fetal HPA-1a.

Arch Med Sci 2018 Aug 15;14(5):1041-1047. Epub 2016 Nov 15.

Department of Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.

Introduction: Pregnant women negative for human platelet antigen 1a (HPA-1a) are at risk of alloimmunization with fetal HPA-1a antigen inherited from the father, and their offspring may develop fetal and neonatal alloimmune thrombocytopenia (FNAIT). The aim of this study was to analyze the frequency of HPA-1a alloimmunization in pregnant Polish women, the feasibility of using maternal platelets for intrauterine transfusions in women subjected to diagnostic fetal blood sampling (FBS) and to discuss potential consequences of alloimmunization.

Material And Methods: Fifteen thousand two hundred and four pregnant women were typed for HPA-1a; HPA-1a negative were screened for anti-HPA-1a. Read More

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August 2018
8 Reads
1.890 Impact Factor

and Allele Frequencies Among Southern Thai Blood Donors.

Indian J Hematol Blood Transfus 2018 Jul 10;34(3):506-509. Epub 2017 Oct 10.

4Graduate Program, Faculty of Allied Health Sciences, Thammasat University, Pathumtani, Thailand.

Diego (DI) blood group genotyping is clinically important in Asian populations. Data of Diego blood type among southern Thais is still unknown. This study aimed to report and allele frequencies in southern Thai blood donors and to estimate potential risk of Di incompatibility and alloimmunization in Thai populations. Read More

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July 2018
9 Reads

Impact of Red Blood Cell Antigen Matching on Alloimmunization and Transfusion Complications in Patients with Sickle Cell Disease: A Systematic Review.

Transfus Med Rev 2018 Jul 26. Epub 2018 Jul 26.

Department of Hematology & Oncology, Emory University School of Medicine, Atlanta, GA.

Red blood cells (RBC) transfusion is critical in managing acute and chronic complications in sickle cell disease (SCD); however, it is complicated by RBC alloimmunization, iron overload, transfusion reactions and infection. Several reports documented an increased incidence of alloantibodies in transfused individuals with SCD, especially for Rh and Kell antigens. As a result, the National Institutes of Health Expert Panel and British Society for Haematology guidelines recommend primary matching for C/c, E/e and K antigens in addition to ABO/RhD for RBC transfusions. Read More

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July 2018
16 Reads

Transplant nephrectomy after graft failure: is it so risky? Impact on morbidity, mortality and alloimmunization.

Int Urol Nephrol 2018 Oct 17;50(10):1787-1793. Epub 2018 Aug 17.

Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.

Purpose: To determine the impact of transplant nephrectomy on morbidity and mortality and HLA immunization.

Methods: All patients who underwent transplant nephrectomy in our centre between 2000 and 2016 were included in this study. A total of 2822 renal transplantations and 180 transplant nephrectomies were performed during this period. Read More

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October 2018
3 Reads

Red Blood Cell Alloimmunization in the Pregnant Patient.

Transfus Med Rev 2018 10 19;32(4):213-219. Epub 2018 Jul 19.

Children's National Health System, Washington, D.C., USA; The George Washington University, Departments of Pediatrics & Pathology, Washington, DC, USA.

Alloimmunization to red blood cell (RBC) antigens represents a challenge for physicians caring for women of child bearing potential. Exposure to non-self RBC antigens may occur during transfusion or pregnancy leading to the development of antibodies. If a subsequent fetus bears that antigen, maternal antibodies may attack the fetal red blood cells causing red cell destruction and clinically significant hemolytic disease of the fetus and newborn (HDFN). Read More

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October 2018
20 Reads

A Conceptual Framework for Optimizing Blood Matching Strategies: Balancing Patient Complications Against Total Costs Incurred.

Front Med (Lausanne) 2018 25;5:199. Epub 2018 Jul 25.

Department of Transfusion Technology Assessment, Sanquin Research, Amsterdam, Netherlands.

Alloimmunization is currently the most frequent adverse blood transfusion event. Whilst completely matched donor blood would nullify the alloimmunization risk, this is practically infeasible. Current matching strategies therefore aim at matching a limited number of blood groups only, and have evolved over time by systematically including matching strategies for those blood groups for which (serious) alloimmunization complications most frequently occurred. Read More

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July 2018
2 Reads

Predicted S and s phenotypes from genotyping results among Thai populations to prevent transfusion-induced alloimmunization risks.

Transfus Apher Sci 2018 Aug 1;57(4):582-586. Epub 2018 Aug 1.

Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Pathumtani, Thailand.

Background: S and s antigens of the MNS system are of clinical importance because alloanti-S and -s have usually caused delayed hemolytic transfusion reactions and hemolytic disease of the fetus and newborn. Various red cell genotyping has been established to predict the phenotypes to solve serological test limitations.

Objectives And Methods: This study aimed to determine S and s genotype frequencies and to estimate the alloimmunization risks among central, northern and southern Thai populations. Read More

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August 2018
12 Reads

Predicting anti-Kell-mediated hemolytic disease of the fetus and newborn: diagnostic accuracy of laboratory management.

Am J Obstet Gynecol 2018 Oct 29;219(4):393.e1-393.e8. Epub 2018 Jul 29.

Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands; Department of Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, The Netherlands; Department of Clinical Transfusion Research, Sanquin Research, Amsterdam, The Netherlands.

Background: There is controversy on critical cut-off values of laboratory testing to select pregnancies at increased risk for anti-Kell-mediated hemolytic disease of the fetus and newborn. Without early detection and treatment, anti-Kell-mediated hemolytic disease of the fetus and newborn may result in progressive fetal anemia, fetal hydrops, asphyxia, and perinatal death.

Objective: We aimed to determine the value of repeated anti-Kell titer determination and biological activity measurement using the antibody-dependent cellular cytotoxicity test determination in the management of pregnancies at risk for anti-Kell-mediated hemolytic disease of the fetus and newborn. Read More

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October 2018
22 Reads

Clinical and epidemiological profile of alloimmunized and autoimmunized multi-transfused patients against red blood cell antigens in a blood center of Minas Gerais.

Hematol Transfus Cell Ther 2018 Apr-Jun;40(2):107-111. Epub 2018 Feb 17.

Hemocentro Regional de Uberaba, Fundação Hemominas, Uberaba, MG, Brazil.

Background: The large diversity of red blood cell antigens favors, especially in multi-transfused patients, the occurrence of autoimmunization and alloimmunization with the risk of hemolytic transfusion reactions. Thus, this study aimed to determine the rates of alloimmunization and autoimmunization in these individuals, as well as the types of alloantibodies and their systems, clinical and epidemiological aspects and the frequency of autoimmunity in alloimmunized and non-alloimmunized patients.

Methods: In a retrospective study, 153 multi-transfused patients from 2006 to 2014 were evaluated. Read More

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February 2018
2 Reads

SMFM Consult Series #46: Evaluation and management of polyhydramnios.

Am J Obstet Gynecol 2018 Oct 23;219(4):B2-B8. Epub 2018 Jul 23.

Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA.

Polyhydramnios, or hydramnios, is an abnormal increase in the volume of amniotic fluid. Identification of polyhydramnios should prompt a search for an underlying etiology. Although most cases of mild polyhydramnios are idiopathic, the 2 most common pathologic causes are maternal diabetes mellitus and fetal anomalies, some of which are associated with genetic syndromes. Read More

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October 2018
23 Reads

Frequency of Red Blood Cell Antigens According to Parent Ethnicity in Korea Using Molecular Typing.

Ann Lab Med 2018 Nov;38(6):599-603

The Division of Human Blood Safety Surveillance, Korea Centers for Disease Control and Prevention, Cheongju, Korea.

Frequencies of red blood cell (RBC) blood group antigens differ by ethnicity. Since the number of immigrants is increasing in Korea, RBC antigens should be assessed in children/youths with parents of different ethnicities to ensure safe transfusions. We investigated the frequency of RBC antigens, except for ABO and RhD, in 382 children and youths with parents having Korean and non-Korean ethnicities. Read More

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November 2018
7 Reads

genotype matching for transfusion support in sickle cell disease.

Blood 2018 Sep 19;132(11):1198-1207. Epub 2018 Jul 19.

Laboratory of Immunohematology and Genomics, New York Blood Center, New York, NY.

Rh alloimmunization remains a challenge for patients with sickle cell disease (SCD) despite transfusion of serologic Rh C, E, and K antigen-matched red cells. Inheritance of altered alleles contributes to the prevalence of Rh antibodies after blood transfusion in patients with SCD and explains approximately one-third of cases. The remainder seem to be stimulated by altered Rh proteins on African American donor red cells. Read More

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September 2018
16 Reads

A cold scare: Formation of cold reactive anti-A1 coinciding with gross hemolysis.

Pract Lab Med 2018 Nov 7;12:e00100. Epub 2018 May 7.

Department of Pathology and Laboratory Medicine, Michael J. Crescenz Veteran Affairs, Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104, United States.

Anti-A antibodies can be found as a usually clinically insignificant naturally occurring cold IgM antibody in A-subgroup patients. It is known from multiple prior case reports that warm-reactive anti-A that reacts at 37 °C can be clinically significant, and it has been previously reported that it could form after alloimmunization with donor A red blood cell (RBC) transfusion. In addition, the development of anti-A, often as an autoantibody, have been described in the setting of various malignancies, perhaps due to expressed subtle alterations of the ABO antigens provoking an immune response. Read More

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November 2018
5 Reads

Clinically significant naturally occurring anti-N and anti-S in a blood donor: a rare finding.

Immunohematology 2018 Jun;34(2):66-68

Department of Transfusion Medicine Medanta-The Medicity.

Conclusions: To the Editors: Alloimmunization is triggered when an individual whose red blood cells (RBCs) are lacking particular antigens is exposed to these antigens through transfusion or pregnancy, causing the formation of immune antibodies. In addition to these exogenous exposures, underlying inflammatory or autoimmune conditions may lead to formation of unexpected antibodies. Individual factors also play a role, since some people are responders and others are non-responders. Read More

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June 2018
5 Reads

Rh and Kell blood group antigen prevalence in a multi-ethnic cohort in Nigeria: implications for local transfusion service.

Immunohematology 2018 Jun;34(2):61-65

Department of Hematology and Blood Transfusion, University of Benin Teaching Hospital, Benin City, Nigeria.

Conclusions: Antigens belonging to the Rh and Kell blood group systems are of major clinical significance because of their immunogenicity and the potential of their consequent antibodies to cause in vivo destruction of exogenous red blood cells (RBCs). Despite the wide-spread use of transfusion, there are sparse data on the prevalence of Rh and Kell system antigens and their ethnic variability in Nigeria. The objective of this study was to determine the prevalence of the five major Rh (D, C, c, E, e) and Kell (K) system antigens in Nigeria with the goal of understanding alloimmunization risk in transfusion recipients and improving transfusion safety through the availability of resources, such as antisera for extended RBC typing and antigen panels for alloantibody detection. Read More

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June 2018
2 Reads

Improvement of maternal and fetal outcomes in women with sickle cell disease treated with early prophylactic erythrocytapheresis.

Transfusion 2018 Sep 8;58(9):2192-2201. Epub 2018 Jul 8.

Department of Medicine, University of Verona and AOUI-Verona, Policlinico GB Rossi, Verona, Italy.

Background: The desire for pregnancy in sickle cell disease (SCD) women has become a true challenge for hematologists, requiring a multidisciplinary approach. Erythrocytapheresis (ECP) is an important therapeutic tool in SCD, but only limited data on starting time and the effects of ECP during pregnancy are available.

Study Design And Methods: This is a double-center retrospective cross-sectional study on a total of 46 single pregnancies in SCD women from January 2008 to June 2017. Read More

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September 2018
7 Reads