Immunohematology最新文献

{"title":"Transfusion of incompatible blood to a patient with alloanti-Sc1.","authors":"C E George,&nbsp;S Grimsley,&nbsp;R Cumber,&nbsp;N Thornton,&nbsp;H Davies,&nbsp;C Harris,&nbsp;E Massey,&nbsp;K Perera","doi":"10.21307/immunohematology-2023-011","DOIUrl":"https://doi.org/10.21307/immunohematology-2023-011","url":null,"abstract":"<p><p>Sc1 is a high-prevalence blood group antigen that is part of the Scianna blood group system. The clinical significance of Scianna antibodies is not well understood because of their rarity; there are only a handful of cases in the literature. This scarcity of information can make it difficult to decide on the best course of action when transfusing a patient with alloantibodies to Scianna blood group antigens. We describe a case of an 85-year-old woman presenting with melena and a hemoglobin of 66 g/L. Upon request for crossmatched blood, a panreactive antibody was found, later elucidated to be alloanti-Sc1. Because of the urgent nature of the transfusion, the patient was transfused with 2 incompatible, presumed Sc1+, red blood cell units with no evidence of an acute or delayed transfusion reaction. This case has been shared with the International Society of Blood Transfusion Rare Donor Working Party, via their Outcome of Incompatible Transfusion form, and adds to the body of evidence on clinical significance of antibodies to the antigens of the Scianna blood group system.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 2","pages":"70-71"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contents.","authors":"","doi":"10.21307/immunohematology-2023-008","DOIUrl":"https://doi.org/10.21307/immunohematology-2023-008","url":null,"abstract":"","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 2","pages":"i-iii"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9895061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The monocyte monolayer assay, an <i>in vitro</i> method for prediction of <i>in vivo</i> survival of transfused incompatible red blood cells: a review.","authors":"S J T Nance","doi":"10.21307/immunohematology-2023-010","DOIUrl":"https://doi.org/10.21307/immunohematology-2023-010","url":null,"abstract":"<p><p>It has long been a goal of transfusion medicine scientists to predict which patients will make clinically significant antibodies when transfused with donor red blood cells (RBCs). But this goal has yet to be achieved. Not all patients have an adverse response to an RBC transfusion by making an antibody to an RBC antigen, and for patients who do, in most cases, they form antibodies to common antigens for which provision of antigen-negative RBCs is not difficult. However, for patients who make antibodies to many antigens and for patients who make an antibody requiring rare blood that is negative for a high-prevalence antigen, knowing the clinical significance of that patient's antibody is important for effective and timely transfusion. This review of the literature provides information on the monocyte monolayer assays (MMAs) developed to predict the outcome of incompatible RBC transfusion. One of these assays has been used for almost 40 years in the United States to predict the outcome of RBC transfusion in patients with alloantibodies for whom provision of rare RBCs is very difficult. Because all transfusion medicine facilities and blood centers will not likely implement the MMA, it is important that the selection of the referral laboratory be carefully made. The MMA is a proven test in the prediction of incompatible transfusion outcomes in patients with IgG-only antibodies. It has been helpful in decision-making when rare blood components are not available or not available quickly, although decisions on blood transfusion must be made by the physician attending the patient and blood should not be withheld waiting for the MMA result in an urgent situation.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 2","pages":"61-69"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10269001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of results from antihuman globulin-graded reactions with the monocyte monolayer assay.","authors":"K Bowman,&nbsp;L A Peña Marquez,&nbsp;L Hawthorne,&nbsp;K Billingsley,&nbsp;S Kelham,&nbsp;S Liang,&nbsp;M Kalvelage","doi":"10.21307/immunohematology-2023-013","DOIUrl":"https://doi.org/10.21307/immunohematology-2023-013","url":null,"abstract":"<p><p>Blood transfusions are a common medical treatment. Risks arise when compatible blood is not available. This study assesses the correlation between antibody reaction strength at the antihuman globulin (AHG) phase of testing and the antibody clinical significance as predicted using the monocyte monolayer assay (MMA). Multiple examples of anti-K donor plasma samples were selected to sensitize K+k+ red blood cells (RBCs). Reactivity was confirmed by testing the sensitized K+k+ RBCs at saline-AHG. Antibody titers were determined by serial dilution using neat plasma. Sixteen samples were selected for the study based on comparable graded reactions with neat plasma (1+, 2+, 3+, and 4+) and similar titration endpoints. Each sample was used to sensitize the same Kk donor and then tested by monocytes to evaluate the clinical significance using the MMA, an <i>in vitro</i> procedure that mimics <i>in vivo</i> extravascular hemolysis to predict the survivability of incompatible transfused RBCs. The monocyte index (MI), i.e., the percentage of RBCs adhered, ingested, or both versus free monocytes, was calculated for each sample. Regardless of the reaction strength, all examples of anti-K were predicted to be clinically significant. While anti-K is known to be clinically significant, the immunogenicity rate of K ensures ample supply of antibody samples for inclusion in this project. This study demonstrates that <i>in vitro</i> antibody strength is highly subjective and variable. These results show no correlation between graded reaction strength at AHG and the predicted clinical significance of an antibody as assessed using the MMA.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 2","pages":"77-81"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10269000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The LW blood group system: not just \"tagging along\" with D.","authors":"E C McGowan,&nbsp;J R Storry","doi":"10.21307/immunohematology-2023-012","DOIUrl":"https://doi.org/10.21307/immunohematology-2023-012","url":null,"abstract":"<p><p>This update of the Landsteiner-Wiener (LW) blood group system (Grandstaff Moulds MK. The LW blood group system: a review. Immunohematology 2011;27:136-42. Storry JR. Review: the LW blood group system. Immunohematology 1992;8:87-93) reports new information on the distribution of genetic variants in ICAM4 and reviews the complex serologic identification of the high-prevalence LWEM antigen. The role of ICAM4 in sickle cell disease and malaria susceptibility is discussed.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 2","pages":"72-76"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.21307/immunohematology-2023-014","DOIUrl":"https://doi.org/10.21307/immunohematology-2023-014","url":null,"abstract":"","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 2","pages":"82"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of immunohematologic testing in mother and newborn ABO incompatibility.","authors":"J Novoselac,&nbsp;K Buzina Marić,&nbsp;V Rimac,&nbsp;I Selak,&nbsp;M Raos,&nbsp;B Golubić Ćepulić","doi":"10.21307/immunohematology-2023-009","DOIUrl":"https://doi.org/10.21307/immunohematology-2023-009","url":null,"abstract":"<p><p>The aim of this study was to define risk factors for jaundice and anemia in newborns with a positive direct antiglobulin test (DAT) and/or with an incompatible crossmatch due to ABO incompatibility between mother and newborn. ABO incompatibility has become a more significant cause of hemolytic disease of the fetus and newborn since the introduction of effective anti-D prophylaxis. The condition is common and, if clinically significant at all, causes only mild jaundice, which can be treated with phototherapy (PT). However, rare and serious presentations, requiring transfusion therapy, have been noted. Clinical, laboratory, and immunohematologic data were collected retrospectively from medical records of ABO-incompatible newborns and their mothers over a 5-year period (2016-2020) from University Hospital Centre Zagreb. Two groups of newborns were compared: those who needed medical intervention because of hyperbilirubinemia or anemia and those who did not. Within the group of newborns requiring intervention, we also compared those with A and B blood groups. Over the 5-year period, 72 of 184 (39%) newborns required treatment. The treatment was PT in 71 (38%) newborns and erythrocyte transfusion in 2 (1%). In 112 (61%) newborns, ABO incompatibility was an accidental finding while performing blood group typing; these newborns did not require any therapy. In conclusion, we found a statistical, but not clinically significant, difference between the groups of treated and untreated newborns, related to the mode of delivery and DAT positivity within hours of delivery. There were no statistically significant differences in characteristics between the groups of treated newborns, except for two newborns with blood group A who received erythrocyte transfusions.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 2","pages":"55-60"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical evaluation of a warm-reactive anti-M.","authors":"X Yang,&nbsp;J M Syrjamaki,&nbsp;P A Ruegsegger,&nbsp;C T Rohrer,&nbsp;W N Rose","doi":"10.21307/immunohematology-2023-004","DOIUrl":"https://doi.org/10.21307/immunohematology-2023-004","url":null,"abstract":"<p><p>Anti-M is usually a naturally occurring antibody directed against M in the MNS blood group system. It does not require exposure to the antigen from previous transfusion or pregnancy. Anti-M is usually of the immunoglobulin M (IgM) isotype, binds best at about 4°C, binds well at room temperature, and rarely binds at 37°C. As a result of its lack of binding at 37°C, anti-M is usually clinically insignificant. There have been rare cases reported of an anti-M that reacts at 37°C. Such an exceptional anti-M may cause hemolytic transfusion reactions. We report a case of a warm-reactive anti-M and the investigational process used to identify it.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 1","pages":"15-18"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9263150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SID: a new carbohydrate blood group system based on a well-characterized but still mysterious antigen of great pathophysiologic interest.","authors":"L Stenfelt,&nbsp;Å Hellberg,&nbsp;M L Olsson","doi":"10.21307/immunohematology-2023-002","DOIUrl":"https://doi.org/10.21307/immunohematology-2023-002","url":null,"abstract":"<p><p>The high-prevalence blood group antigen, Sd^a, had been puzzling blood bankers and transfusionists for at least a decade when it was reported in 1967. The characteristic mix of agglutinates and free red blood cells (RBCs), caused by anti-Sd^a, is seen with the RBCs from 90 percent of individuals of European descent. However, only 2-4 percent of individuals are truly Sd(a-) and may produce anti-Sd^a. The antibodies, generally considered insignificant, may cause hemolytic transfusion reactions with high-expressing Sd(a+) RBCs (e.g., the unusual Cad phenotype, which can also be polyagglutinable). The Sd^a glycan, GalNAcβ1-4(NeuAcα2-3)Gal-R, is produced in the gastrointestinal and urinary systems, while its origin on RBCs is more controversial. According to current theory, Sd^a is likely to be passively adsorbed in low amounts, except in Cad individuals, where it has been found on erythroid proteins and at higher levels. The long-standing hypothesis that <i>B4GALNT2</i> encodes the Sd^a synthase was confirmed in 2019, since homozygosity for a variant allele with rs7224888:C produces a non-functional enzyme associated with most cases of the Sd(a-) phenotype. Thereby, the SID blood group system was acknowledged as number 038 by the International Society of Blood Transfusion. Although the genetic background of Sd(a-) was settled, questions remain. The genetic background of the Cad phenotype has not yet been determined, and the source of the RBC-carried Sd^a is unknown. Furthermore, the interest of Sd^a stretches beyond transfusion medicine. Some tantalizing examples are lowered antigen levels in malignant tissue compared with normal tissue and interference with infectious agents like <i>Escherichia coli</i>, influenza virus, and malaria parasites.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9263152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of the serologic and molecular basis of D variants with a focus on D variants in the Indian population.","authors":"D S Parchure,&nbsp;G V Mishra,&nbsp;S S Kulkarni","doi":"10.21307/immunohematology-2023-005","DOIUrl":"https://doi.org/10.21307/immunohematology-2023-005","url":null,"abstract":"<p><p>Complexities of D within the Rh blood group system have long been recognized, initially using basic serologic testing and, more recently, using advanced and sensitive typing reagents. Discrepancies may arise when an individual carries a D antigen showing altered D antigen expression. These D variants are clinically important, since they may lead to production of anti-D in the carrier and induce alloimmunization in D- recipients, making their correct identification imperative. For clinical purposes, D variants can be classified into three groups: weak D, partial D, and DEL. The problem surrounding proper characterization of D variants exists because routine serologic tests are sometimes inadequate to detect D variants or resolve discrepant or ambiguous D typing results. Today, molecular analysis has revealed more than 300 <i>RH</i> alleles and is a better method for investigating D variants. Global distribution of variants differs, as observed in European, African, and East Asian populations. Discovery of the novel <i>RHD*01W.150</i> (weak D type 150) with a nucleotide change of c.327_487-4164dup is proof. This variant, the result of an insertion of a duplicated exon 3 between exons 2 and 4 in the same orientation, was detected in more than 50 percent of Indian D variant samples in a 2018 study. The outcome of studies worldwide has led to the recommendation to manage D variant individuals as D+ or D- according to <i>RHD</i> genotype. The policies and workup with respect to D variant testing in donors, recipients, and prenatal women differ among blood banks, depending on type of variants predominantly encountered. Thus, a general genotyping protocol cannot be followed globally, and an Indian-specific <i>RHD</i> genotyping assay (multiplex polymerase chain reaction) designed to detect D variants frequently found in the Indian population was developed to save time and resources. This assay is also helpful for detecting several partial and null alleles. Identification of D variants by serology and characterization by molecular testing need to go hand-in-hand for better and safer transfusion practices.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 1","pages":"19-31"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9263144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}