169 results match your criteria Erythrocyte Alloimmunization and Pregnancy


Maternal-fetal alloimmunization: perinatal outcomes in a reference hospital in Northeastern Brazil.

Rev Assoc Med Bras (1992) 2022 May;68(5):670-674

Universidade Federal do Ceará, Maternidade Escola Assis Chateaubriand, Serviço de Medicina Fetal - Fortaleza (CE), Brazil.

Objective: To assess the prevalence of maternal alloantibodies in pregnant women at a maternity hospital in northeastern Brazil and describe their perinatal outcomes.

Methods: A retrospective cohort study reviewed maternal and newborn medical records between January 2017 and October 2018 to assess for the presence of maternal alloantibodies.

Results: The following maternal alloantibodies were found in the 41 cases surveyed: anti-D, 28 cases (45%); anti-C, 7 cases (11%); anti-c, 1 case (1. Read More

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Maternal bleeding complications in pregnancies affected by red blood cell alloimmunization.

Eur J Obstet Gynecol Reprod Biol 2022 Apr 4;271:271-277. Epub 2022 Mar 4.

Medical University of Vienna, Department of Obstetrics and Gynecology, Austria.

Objective: To investigate whether women with red blood cell (RBC) alloimmunization are more likely to experience bleeding complications during pregnancy or delivery than women without RBC alloimmunization.

Study Design: Retrospective study involving all singleton pregnancies affected by RBC alloimmunization and without pre-existing maternal bleeding disorders or placenta previa, from 1 July 1999 to 30 June 2019 ("cases"). Only bleedings not related to invasive procedures (amnio- or cordocenteses) were included. Read More

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The rate of decline in fetal hemoglobin following intrauterine blood transfusion in the management of red cell alloimmunization.

Eur J Obstet Gynecol Reprod Biol 2022 Apr 12;271:93-96. Epub 2022 Feb 12.

UCD Perinatal Research Centre, School of Medicine, University College Dublin, The National Maternity Hospital, Dublin, Ireland; Fetal Medicine Department, The National Maternity Hospital, Dublin, Ireland.

Objective: Hemolytic disease of the fetus and newborn is characterized by fetal anemia, secondary to maternal alloantibody-mediated fetal erythrocyte destruction. Despite our reliance on intrauterine blood transfusion (IUT) to maintain severely affected pregnancies, it remains difficult to predict the fetal response to an infusion of donor blood. Our objective was to determine the daily rate of decline in fetal hemoglobin following one, two, and three transfusions. Read More

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Management and clinical consequences of red blood cell antibodies in pregnancy: A population-based cohort study.

Acta Obstet Gynecol Scand 2021 Dec 2;100(12):2216-2225. Epub 2021 Sep 2.

Center for Fetal Medicine, Pregnancy Care and Delivery, Karolinska University Hospital, Stockholm, Sweden.

Introduction: Anti-D alloimmunization is the most common cause of severe hemolytic disease of the fetus and newborn (HDFN). The management of pregnancies affected by less frequent red blood cell (RBC) antibodies poses a challenge to clinicians, and perinatal outcomes are less well described. This study aimed to describe the frequency of clinically significant RBC antibodies in our pregnant population and analyze the risk of prenatal and postnatal treatment for HDFN in relation to our national risk classification system and management guidelines. Read More

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December 2021

Rate of RhD-alloimmunization after the transfusion of multiple RhD-positive primary red blood cell-containing products.

Transfusion 2021 07;61 Suppl 1:S150-S158

Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Introduction: Early transfusion reduces mortality in bleeding patients. In this setting, RhD-positive blood products might be transfused. This study determined the association between the RhD-alloimmunization rate and the number of RhD-positive products transfused. Read More

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Perception of risk in massive transfusion as it relates to fetal outcomes: A survey of surgeons and nurses at one American trauma center.

Transfusion 2021 07;61 Suppl 1:S159-S166

Center for Injury Science and Division of Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Background: The use of blood products early in the resuscitation of bleeding trauma patients is widely accepted, but made difficult by limited supplies of D- red blood cell (RBC)-containing products. Use of D+ RBC-containing products would alleviate this issue, but could lead to alloimmunization. Risk associated with transfusing D+ RBC in emergency bleeding situations is being reconsidered. Read More

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Antigen matching for transfusion support in Brazilian female patients with sickle cell disease to reduce RBC alloimmunization.

Transfusion 2021 08 14;61(8):2458-2467. Epub 2021 Jun 14.

Departamento de Ginecologia, Unifesp (Universidade Federal de São Paulo), São Paulo, Brazil.

Background: Red blood cell (RBC) alloimmunization is a complication of patients with sickle cell disease (SCD) and it has a greater impact on pregnancy, leading to a risk of hemolytic disease of the newborn and reducing blood availability for pregnant women. This study proposed to evaluate antigen matching transfusion protocols, aiming to reduce RBC alloimmunization in Brazilian female patients with SCD.

Methods: Samples from female patients with SCD (153) and self-declared Afro-Brazilian donors (307) were genotyped for RBC antigens and RH variants were investigated. Read More

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A comparative study on perinatal outcomes of red blood cell-alloimmunized pregnancies with anti-RhD in combination and anti-RhD alone in China.

Vox Sang 2022 Feb 10;117(2):268-274. Epub 2021 Jun 10.

Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Background And Objectives: The advent of intrauterine transfusion (IUT) has improved the survival of severe foetal anaemia. The aim of this study was to compare the perinatal outcomes of red blood cell (RBC)-alloimmunized pregnancies with anti-RhD in combination and anti-RhD alone in China.

Materials And Methods: A retrospective study was conducted involving RBC-alloimmunized pregnancies with anti-RhD in combination and anti-RhD alone admitted to The First Affiliated Hospital, Sun Yat-sen University, between January 2007 and December 2019. Read More

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February 2022

Prevalence and Specificity of Red Cell Alloantibodies in Un-Transfused Multiparous Women.

Clin Lab 2021 Apr;67(4)

Background: Maternal alloantibodies may have devastating effects on the fetal red cells leading to hemolytic disease of the fetus and newborn (HDFN). The purpose of this study was to observe the prevalence and specificity of red cell alloantibodies in untransfused multiparous women.

Methods: This study was conducted at the Baqai Institute of Hematology, Baqai Medical University and Husaini blood bank Karachi, Pakistan. Read More

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Antibodies to Low-Copy Number RBC Alloantigen Convert a Tolerogenic Stimulus to an Immunogenic Stimulus in Mice.

Front Immunol 2021 12;12:629608. Epub 2021 Mar 12.

Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, United States.

Red blood cells expressing alloantigens are well known to be capable of inducing robust humoral alloantibody responses both in transfusion and pregnancy. However, the majority of transfusion recipients and pregnant women never make alloantibodies, even after repeat exposure to foreign RBCs. More recently, RBCs have been used as a cellular therapeutic-very much like transfusion, engineered RBCs are highly immunogenic in some cases but not others. Read More

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September 2021

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

Transfusion 2021 05 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

Reduction of anti-K-mediated hemolytic disease of newborns after the introduction of a matched transfusion policy: A nation-wide policy change evaluation study in the Netherlands.

Transfusion 2021 03 2;61(3):713-721. Epub 2021 Feb 2.

Department of Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, The Netherlands.

Background: During pregnancy, maternal red blood cell (RBC) antibodies can lead to life-threatening fetal hemolysis and anemia. Women can become immunized by a pregnancy or an unmatched transfusion. Our aim was to quantify the effect of a nationwide K-matched transfusion policy for women of childbearing age potential to prevent K-immunization in pregnancy. Read More

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The risk to future pregnancies of transfusing Rh(D)-negative females of childbearing potential with Rh(D)-positive red blood cells during trauma resuscitation is dependent on their age at transfusion.

Vox Sang 2021 Aug 25;116(7):831-840. Epub 2021 Jan 25.

Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Background: A risk assessment model for predicting the risk of haemolytic disease of the fetus and newborn (HDFN) in future pregnancies following the transfusion of Rh(D)-positive red blood cell (RBC)-containing products to females of childbearing potential (FCP) was developed, accounting for the age that the FCP is transfused in various countries.

Methods: The HDFN risk prediction model included the following inputs: risk of FCP death in trauma, Rh(D) alloimmunization rate following Rh(D)-positive RBC transfusion, expected number of live births following resuscitation, probability of carrying an Rh(D)-positive fetus, the probability of HDFN in an Rh(D)-positive fetus carried by an alloimmunized mother. The model was implemented in Microsoft R Open, and one million FCPs of each age between 18 and 49 years old were simulated. Read More

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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

Title: Effect of multiple maternal red cell alloantibodies on the occurrence and severity of Hemolytic Disease of the Fetus and Newborn.

Transfus Apher Sci 2021 Feb 23;60(1):102958. Epub 2020 Sep 23.

Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Introduction: Antenatal antibody screening in India is focused on the detection of anti-D in RhD-negative mothers. HDFN outcome can also be affected by the presence of antibodies other than anti-D. We planned this study to find the impact of 'anti-D in combination with additional antibodies' on the development and severity of HDFN compared with 'anti-D alone'. Read More

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February 2021

Impact of RHD genotyping on transfusion practice in Denmark and the United States and identification of novel RHD alleles.

Transfusion 2021 01 25;61(1):256-265. Epub 2020 Sep 25.

Laboratory of Immunohematology and Genomics, New York Blood Center Enterprise, New York, New York, USA.

Background: Reduced D antigen on red blood cells (RBCs) may be due to "partial" D phenotypes associated with loss of epitope(s) and risk for alloimmunization or "weak" D phenotypes that do not lack major epitopes with absence of clinical complications. Genotyping of samples with weak and discrepant D typing is recommended to guide transfusion and RhIG prophylaxis. The goal was to compare the impact of RHD genotyping on transfusion practice in two centers serving different populations. Read More

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January 2021

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

Impact of red blood cell alloimmunization on fetal and neonatal outcomes: A single center cohort study.

Transfusion 2020 11 7;60(11):2537-2546. Epub 2020 Sep 7.

Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.

Background: Alloimmunization can impact both the fetus and neonate.

Study Objectives: (a) calculate the incidence of clinically significant RBC isoimmunization during pregnancy, (b) review maternal management and neonatal outcomes, (c) assess the value of prenatal and postnatal serological testing in predicting neonatal outcomes.

Study Design And Methods: A retrospective audit of consecutive alloimmunized pregnancies was conducted. Read More

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November 2020

Red blood cell alloimmunization prevalence and hemolytic disease of the fetus and newborn in Israel: A retrospective study.

Transfusion 2020 11 8;60(11):2684-2690. Epub 2020 Aug 8.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Hemolytic disease of the fetus and newborn (HDFN) is a severe form of anemia caused by maternal antibodies against fetal red blood cells (RBC) that can cause intrauterine and perinatal morbidity and mortality. The prevalence and specificities of alloantibodies among Israeli pregnant women and clinical outcomes for their fetuses and newborns are unknown.

Study Design And Methods: A retrospective study of women who gave birth between January 1, 2011, and December 31, 2011, was performed. Read More

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November 2020

Approach to red blood cell antibody testing during pregnancy: Answers to commonly asked questions.

Can Fam Physician 2020 07;66(7):491-498

Transfusion Medicine Specialist in the Department of Laboratory Medicine and Pathobiology at the University Health Network in Toronto, Assistant Professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto, a consultant in the neonatal intensive care unit and in the Department of Laboratory Medicine and Molecular Diagnostics at Sunnybrook Health Sciences Centre, and Program Investigator in the Quality in Utilization, Education, and Safety in Transfusion (QUEST) research collaboration at the University of Toronto.

Objective: To provide family physicians with an understanding of blood bank tests performed during pregnancy. The value of routine blood type and antibody tests, as well as the follow-up required when a patient develops a red blood cell antibody or experiences a fetal-maternal hemorrhage (FMH) will be reviewed.

Sources Of Information: The approach described is based on the authors' clinical expertise and peer-reviewed literature from 1967 to 2020. Read More

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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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