152 results match your criteria Erythrocyte Alloimmunization and Pregnancy


HLA-DRB1 molecules and the presentation of anchor peptides from RhD, RhCE, and KEL proteins.

Transfusion 2021 May 5;61(5):1617-1630. Epub 2021 Mar 5.

Department of Clinical and Experimental Oncology, Hematology and Hemotherapy Discipline, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.

Background: Antigens from the Rh and Kell systems are recognized as the most immunogenic in clinical practice. This study evaluated the possible molecular mechanisms involved in the interaction of antigenic peptides with the DRB1 molecules, which help to explain the high frequency of anti-K and association of D + C antibodies in transfusion and incompatible pregnancy.

Study Design And Methods: We included 201 patients with antibodies against antigens from the Rh and Kell systems and compare them with 174,015 controls. Read More

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Association of multispecific red blood cell alloimmunization with HLA-Class II variants is related to Rh phenotypes.

Bratisl Lek Listy 2021 ;122(3):179-183

Aim: It remains unclear, why only some patients form alloantibodies against foreign RBC antigens. Transfusion of red blood cell (RBC) products and pregnancy are the most relevant causes of immunization against RBC alloantigens. Here we investigated the relationship between RBC alloantibodies, Rh phenotype, and HLA phenotype among patients with multiple RBC alloantibodiesMETHODS: In a group of 124 multi-responders ‒ including both pregnant women and transplant recipients ‒ we analysed the distribution of HLA-Class II variants in subgroups of multi-responders to RBC alloantigens according to their Rh status. Read More

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February 2021

The effectiveness of KEL and RHCE fetal genotype assessment in alloimmunized women by minisequencing.

Ceska Gynekol 2020 ;85(3):164-173

Objective: To evaluate the effectiveness of the fetal KEL and RHCE genotype assessment in alloimmunized pregnant women by minisequencing.

Design: Prospective cohort study.

Setting: Obstetrics and Gynecology Clinic of the Faculty of Medicine UP and the University Hospital Olomouc; Institute of Medical Genetics of the Faculty of Medicine UP and the University Hospital Olomouc; Transfusion Department of the University Hospital Olomouc; Institute of Biophysics of the Faculty of Medicine UP Olomouc. Read More

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February 2021

Prevalence of Red Blood Cell Alloimmunization among Transfused Chronic Kidney Disease Patients in Hospital Universiti Sains Malaysia.

Oman Med J 2020 Sep 30;35(5):e177. Epub 2020 Sep 30.

Department of Pathology, Hospital Kuala Krai, Kelantan, Malaysia.

Objectives: Red blood cell (RBC) immunization is a common complication in blood transfusion recipients. Patients with chronic kidney disease (CKD) eventually develop anemia, which is multifactorial, and requires regular blood transfusions, which exposes patients to the development of RBC antibodies. We sought to determine the prevalence and specificity patterns of RBC immunization and its risk factors among transfused CKD patients. Read More

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September 2020

20 Years of Follow-up Alloimmunization and Hemolytic Disease in Newborn: Has Anything Changed in the Field Over the Years?

Klin Padiatr 2020 Nov 15;232(6):314-320. Epub 2020 Oct 15.

Faculty of Economics, University of Mostar, Mostar.

Objective: of the study is to research the epidemiological aspects of maternal alloimmunization against erythrocyte antigens of fetuses (AB0, Rhesus, Lewis, Kell, Duffy and others) and to identify the most common types of hemolytic disease of the newborn (HDN) in the West Herzegovina region.

Study Design: The 20-year retrospective epidemiological study includes all pregnant women who had been immunologically tested and newborn treated for HDN.

Results: The indirect antiglobulin (IAT) detected antibodies against antigens in 545 (1. Read More

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November 2020

Distribution of maternal red cell antibodies and the risk of severe alloimmune haemolytic disease of the foetus in a Chinese population: a cohort study on prenatal management.

BMC Pregnancy Childbirth 2020 Sep 16;20(1):539. Epub 2020 Sep 16.

Department of Obstetrics, the Sixth Affiliated Hospital of Sun Yat-sen University, 510655, Guangzhou, Guangdong, China.

Background: Haemolytic disease of the foetus and newborn (HDFN) is the most common aetiology of haemolytic anaemia and hyperbilirubinaemia in foetuses and neonates. Studies on the distribution of antibodies that cause haemolytic disease of the foetus (HDF) in China are limited, and the effects of multiple antibodies on the severity of HDF need further evaluation.

Methods: An observational cohort study from January 2005 to December 2019 was conducted in two hospitals affiliated with Sun Yat-sen University. Read More

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September 2020

Severe hemolytic disease of the fetus and newborn due to anti-E and anti-Jka.

Immunohematology 2020 Jun;36(2):60-63

Assistant Professor, Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, India.

Conclusions: Red blood cell alloimmunization to antigens other than D, such as C, c, E, e, and antigens in the Kell, MNS, and Duffy blood group systems, has emerged as an important cause of hemolytic disease of the fetus and newborn (HDFN). Antibody screening for these antibodies is not routinely practiced for all antenatal patients in developing countries, mainly because of financial constraints. Here we report a rare case of HDFN due to dual antibodies to Rh and Kidd blood group system antigens: anti-E and anti-Jka. Read More

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Red Blood Cell Alloantibody Titration - Does the Titration Method Matter?

Clin Lab 2020 Jun;66(6)

Background: Red blood cell (RBC) alloantibody titration is a quasi-quantitative method to assess antibody concentration and is considered a useful means of estimating maternal alloimmunization during pregnancy. Traditionally, titration is performed using conventional tube test (CTT). The gel microcolumn agglutination-based method (GMA) has been proven reliable for many immunohematology tests. Read More

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Frequency and clinical significance of red cell antibodies in pregnancy - A prospective study from India.

Indian J Pathol Microbiol 2020 Apr-Jun;63(2):241-246

Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Background: For appropriate management of hemolytic disease of the fetus and newborn (HDFN), it is important to detect irregular red cell antibody in the antenatal period. Though it is a simple one-step method, it is not part of routine antenatal screening in many developing countries. To reiterate the importance of antenatal antibody screening, we have assessed the frequency and clinical significance of irregular red cell antibodies in our patient population. Read More

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January 2021

Poly(I:C) causes failure of immunoprophylaxis to red blood cells expressing the KEL glycoprotein in mice.

Blood 2020 05;135(22):1983-1993

Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT.

Polyclonal anti-D (Rh immune globulin [RhIg]) therapy has mitigated hemolytic disease of the newborn over the past half century, although breakthrough anti-D alloimmunization still occurs in some treated females. We hypothesized that antiviral responses may impact the efficacy of immunoprophylaxis therapy in a type 1 interferon (IFN)-dependent manner and tested this hypothesis in a murine model of KEL alloimmunization. Polyclonal anti-KEL immunoprophylaxis (KELIg) was administered to wild-type or knockout mice in the presence or absence of polyinosinic-polycytidilic acid (poly[I:C]), followed by the transfusion of murine red blood cells (RBCs) expressing the human KEL glycoprotein. Read More

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American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support.

Blood Adv 2020 Jan;4(2):327-355

Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.

Background: Red cell transfusions remain a mainstay of therapy for patients with sickle cell disease (SCD), but pose significant clinical challenges. Guidance for specific indications and administration of transfusion, as well as screening, prevention, and management of alloimmunization, delayed hemolytic transfusion reactions (DHTRs), and iron overload may improve outcomes.

Objective: Our objective was to develop evidence-based guidelines to support patients, clinicians, and other healthcare professionals in their decisions about transfusion support for SCD and the management of transfusion-related complications. Read More

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January 2020

Immunological principle of development of red blood cell alloimmunization in pregnancy, hemolytic disease of the fetus and prevention of RhD alloimmunization in RhD negative women.

Ceska Gynekol 2020 ;85(6):408-416

Design: Review article.

Setting: Department of Obstetrics and Gynecology, Palacky University Olomouc, Faculty of Medicine and Dentistry, University Hospital Olomouc. Methods, results: Every person exposed to a foreign red blood cell antigen (erythrocyte antigen) develops an antibody. Read More

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Isoantibodies, prevalence and risk factors in two hospitals in Mexico

Rev Med Inst Mex Seguro Soc 2019 Jul 31;57(2):88-96. Epub 2019 Jul 31.

Instituto de Seguridad Social del Estado de México y Municipios, Centro Médico Toluca, Departamento de Medicina Transfusional. Metepec, Estado de México, México

Background: Erythrocyte isoimmunization or alloimmunization is a late complication of transfusion, in which antibodies against erythrocyte antigens other than the ABO system are developed. Its prevalence is variable, groups of patients with low prevalence (2%) and others of high risk with more than 50% have been described. These antibodies can have serious clinical repercussions in transfused patients. Read More

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Coordinating Care Across the Perinatal Continuum in Hemolytic Disease of the Fetus and Newborn: The Timely Handoff of a Positive Maternal Anti-Erythrocyte Antibody Screen.

J Pediatr 2019 11 23;214:212-216. Epub 2019 Aug 23.

Division of Newborn Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA.

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November 2019

Clinical Characteristics of Jra Alloimmunization in Pregnancy: A Case Series.

Fetal Diagn Ther 2019 21;46(6):433-439. Epub 2019 Aug 21.

Department of Maternal-Fetal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan.

Only few studies have reported on Jra alloimmunization in pregnancy, and its clinical course remains unclear. We reviewed our cases to clarify the change in the peak systolic velocity of the middle cerebral artery (MCA-PSV) during pregnancy and the critical anti-Jra antibody titer to predict fetal anemia. We collected the data of pregnant women with anti-Jra antibody from two hospitals between 2010 and 2017. Read More

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"Provoked" feto-maternal hemorrhage may represent insensible cell exchange in pregnancies from 6 to 22 weeks gestational age.

Contraception 2019 08 11;100(2):142-146. Epub 2019 Apr 11.

The University of Rochester Medical Center, Rochester, NY.

Objective: To quantify spontaneous and provoked fetal to maternal cell exchange in the first half of pregnancy. Transfer of fetal red blood cells (FRBCs) into the maternal circulation during the first half of pregnancy is poorly characterized but of clinical relevance for miscarriage management and invasive procedures.

Study Design: Prospective, descriptive cohort study of women presenting for surgical termination of pregnancy with sonographically confirmed gestational age (GA). Read More

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How clinically important are non-D Rh antibodies?

Acta Obstet Gynecol Scand 2019 07 24;98(7):877-884. Epub 2019 Feb 24.

Department of Obstetrics and Gynaecology, The University of Melbourne, The Royal Women's Hospital, Parkville, Victoria, Australia.

Introduction: The advent of RhD immunoglobulin prophylaxis to prevent maternal RhD alloimmunization has reduced the incidence of this condition and its associated poor outcomes. Consequently, non-D Rh antibodies now account for a greater proportion of alloimmunized pregnancies. These antibodies have been the subject of comparatively little research. Read More

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

Transfusion 2019 01 14;59(1):217-225. 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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January 2019

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

Blood Adv 2018 11;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

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

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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Maternal red blood cell alloimmunization requiring intrauterine transfusion: a comparative study on management and outcome depending on the type of antibody.

Transfusion 2018 05 6;58(5):1199-1205. Epub 2018 Mar 6.

Department of Obstetrics, Jeanne de Flandre Hospital, CHU Lille, Lille, France.

Background: The antibody primarily responsible for fetal anemia may influence treatment and prognosis. The primary objective was to compare ante- and postnatal management and the outcomes of maternal red blood cell (RBC) alloimmunizations according to the antibody involved. The secondary objective was to compare anti-D alloimmunizations according to associated number of antibodies. Read More

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Management of red blood cell alloimmunization in pregnancy.

J Gynecol Obstet Hum Reprod 2018 May 21;47(5):197-204. Epub 2018 Feb 21.

CHU de Lille, department of obstetrics, 59000 Lille, France.

The main cause of fetal anemia is maternal red blood cell alloimmunization (AI). The search of maternal antibodies by indirect antiglobulin test allows screening for AI during pregnancy. In case of AI, fetal genotyping (for Rh-D, Rh-c, Rh-E and Kell), quantification (for anti-rhesus antibodies) and antibody titration, as well as ultrasound monitoring, are performed. Read More

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Evaluation of a Decision Tree for Efficient Antenatal Red Blood Cell Antibody Screening.

Epidemiology 2018 05;29(3):453-457

Background: Hemolytic disease of the fetus and newborn due to maternal red blood cell alloimmunization can have serious consequences. Because early detection enables careful monitoring of affected pregnancies, programs to routinely screen all pregnant women have been widely adopted. Due to the low prevalence of alloimmunization, these require large investments of resources to detect a small number of cases. Read More

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Successful management of severe red blood cell alloimmunization in pregnancy with a combination of therapeutic plasma exchange, intravenous immune globulin, and intrauterine transfusion.

Transfusion 2018 03 17;58(3):677-684. Epub 2017 Dec 17.

Department of Pathology and Laboratory Medicine, University of Texas McGovern Medical School at Houston, Houston, Texas.

Background: Antibodies to Rhesus and Kell antigens have been associated with severe hemolytic disease of the fetus and newborn (HDFN) necessitating intrauterine transfusion (IUT) of red blood cells (RBCs). We report a case series of five women with severe HDFN secondary to maternal RBC alloimmunization who were successfully managed with therapeutic plasma exchange (TPE), intravenous immune globulin (IVIG), and IUT.

Study Design And Methods: This is a retrospective case series of five women with severe HDFN who underwent a total of three TPE procedures during Weeks 10 to 13 of pregnancy, followed by weekly IVIG infusions. Read More

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Successful management of a severe anti-M alloimmunization during pregnancy.

Eur J Obstet Gynecol Reprod Biol 2017 Oct 4;217:175-176. Epub 2017 Aug 4.

Division of Obstetrics, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCL), B-1200 Bruxelles, Belgium.

We report the successful outcome of a patient with anti-M antibodies with a previous history of severe hemolysis of erythrocytes. Serial plasma exchange from the first trimester combined with ultrasound monitoring of the fetal middle cerebral artery blood velocity was implemented. This management allowed a favorable pregnancy outcome of an infant born by an elective caesarean section at 32 weeks 6/7 with a normal Apgar score at 8/9/10. Read More

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October 2017

Red blood cell alloimmunization in pregnancy during the years 1996-2015 in Iceland: a nation-wide population study.

Transfusion 2017 11 24;57(11):2578-2585. Epub 2017 Aug 24.

University of Iceland, Faculty of Medicine, Reykjavik, Iceland.

Background: Red blood cell (RBC) alloimmunization during pregnancy is still a major problem. Historically, anti-D antibodies are most likely to cause severe hemolysis, but other antibodies are also important. In Iceland, postnatal RhIg prophylaxis was implemented in 1969, universal RBC antibody screening was implemented in 1978, but antenatal RhIg prophylaxis is not yet routine. Read More

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November 2017

High Levels of CXCL8 and Low Levels of CXCL9 and CXCL10 in Women with Maternal RhD Alloimmunization.

Front Immunol 2017 3;8:700. Epub 2017 Jul 3.

Hematology and Hemotherapy Foundation of Pernambuco (HEMOPE), Recife, Brazil.

Maternal RhD alloimmunization is an inflammatory response against protein antigens in fetal red blood cells (RBC). However, not all women become alloimmunized when exposed to RhD fetal RBC. Thus, this study aimed to evaluate levels of inflammatory chemokines in RhD pregnant women with erythrocyte alloimmunization. Read More

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Risks and trends of red blood cell transfusion in obstetric patients: a retrospective study of 45,213 deliveries using administrative data.

Transfusion 2017 09 22;57(9):2197-2205. Epub 2017 Jun 22.

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Background: Transfusion data for obstetric patients are scarce. Identifying characteristics associated with red blood cell transfusion (RBCT) is of importance to better identify patients who would benefit from blood conservation strategies as the risk of alloimmunization from RBCT has the potential to affect the fetus and newborn.

Study Design And Methods: We conducted a retrospective cohort study using hospital administrative data to identify trends and risk factors of RBCT in obstetric patients. Read More

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September 2017

[Identification of alloantibodies and their associations: Balance sheet of 3 years at the Regional Center of Blood Transfusion in Rabat/Morocco and difficult in transfusion management].

Transfus Clin Biol 2017 Nov 31;24(4):422-430. Epub 2017 May 31.

Centre régional de transfusion sanguine, immuno-hématologie, Bab-El-Irfane, rue M'FadeL-Cherka, 10000 Rabat, Maroc.

Red blood cell immunization can lead to delays or even an impasse in a transfusion.

Objectives: Determine the specificities of the most common of alloantibodies and their associations to correct management of red blood cell transfused.

Methods And Materials: A retrospective study between 2013 and 2015 in immunohematology laboratories at the Blood Transfusion Center of Rabat in Morocco. Read More

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November 2017