ARTICLE
31 December 2023

Investigation of Domestic and Foreign Unexpected Antibodies for Emergency Blood Transfusion

Weonjoo Hwang1 Sang-Hee Lee2 Chang-Eun Park3*
Show Less
1 Department of Laboratory Medicine, Pusan National University Hospital, Busan, Republic of Korea
2 Department of Laboratory Medicine, Asan Medical Center, Seoul, Republic of Korea
3 Department of Biomedical Laboratory Science, Molecular Diagnostics Research Institute, Namseoul University, Cheonan, Republic of Korea
© 2023 by the Author(s). Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Certain pre-transfusion tests are not commonly performed during emergency blood transfusion. In this study, we reviewed and analyzed the data from post-blood transfusion antibody screening tests to establish the effects of unexpected antibodies causing hemolytic transfusion reactions. We reviewed information published domestically and internationally and selected the data
from 68,602 antibody screening tests and 528 antibody identification tests conducted at Hospital P. We found cases of unexpected antibody positivity (1198, 1.74%), Rh type (161, 30.49%), Lewis type (Le; 67, 12.69%), and Diego type (Di; 28, 5.30%). Specifically, anti-E type positivity was observed in 93 cases (17.61%), and anti-C in 13 cases (2.46%). Only data from domestic cases that were published before 2007 were included for analysis, which established the presence of the following antibodies and the numbers of cases in each category: anti-E (196, 22.45%), anti-Lea (82, 9.39%), and anti-E+C (60, 6.87%). In 2018, anti-E (107, 17.12%), anti-E+C (56, 8.96%), and anti-Dia (28, 4.48%) were detected. In other domestic cases, anti-E, anti-Lea, and anti-E+C were detected in Hospital S, whereas anti-E, anti-D, anti- E+C, and anti-C+E were detected in Hospital D. In Saudi Arabia, anti-D, anti-E, and anti-Jka was detected. The anti-M, anti-N, anti-Lea, and anti-D were detected in India. Requests for emergency blood transfusion increased 1.8 times after the opening of the trauma center. This study has limitations as it is a cross-sectional study. Further studies are needed to provide basic information on alternative treatments that can increase the safety and reduce the side effects of hemolytic transfusion in emergency transfusion situations.

Keywords
Antibody screening
Anti-E+c
Emergency blood transfusion
Transfusion reaction
Unexpected antibody
References

1. Lim YA, 2022, Advances in Pre-Transfusion Testing and Immunohematology. Korean J Blood Transfus, 33(2): 77–87. https://doi.org/10.17945/kjbt.2022.33.2.77
2. Kim N, Lee J, Kim DS, et al., 2018, Elimination of Causative Antibody by Plasma Exchange in a Patient with an Acute Hemolytic Transfusion Reaction. Korean J Blood Transfus, 29(1): 79–85. https://doi.org/10.17945/kjbt.2018.29.1.79
3. Pathak S, Chandrashekhar M, Wankhede GR, 2011, Type and Screen Policy in the Blood Bank: Is AHG Cross-Match Still Required? A Study at a Multispecialty Corporate Hospital in India. Asian J Transfus Sci, 5(2): 153–156. https://doi.org/10.4103/0973-6247.83242
4. Chaudhary R, Agarwal N, 2011, Safety of Type and Screen Method Compared to Conventional Antiglobulin Crossmatch Procedures for Compatibility Testing in Indian Setting. Asian J Transfus Sci, 5(2): 157–159. https://doi.org/10.4103/0973-6247.83243
5. Kim H-R, Kim H-H, 2013, Applied the “Type and Screen” Method Based on Antibody Screening Test Including Di(a) Cells and Immediate Spin Crossmatch to All Patients Who Received Transfusion for Five Years. Korean J Blood Transfus, 24(3): 258–264.
6. Park S-J, Bae IC, Park YH, et al., 2007, The Usage of Uncrossmatched Group O, Rh-Negative RBCs for Emergency Transfusion. Korean J Blood Transfus, 18(1): 9–14.
7. Lee H-J, Jo S-Y, Shin K-H, et al., 2015, Analysis of Unexpected Antibodies Detected in Children: A Single Center Study for 7 Years. Korean J Blood Transfus, 26(3): 249–256. https://doi.org/10.17945/kjbt.2015.26.3.249
8. Kim J-J, 2018, Frequencies and Distributions of Unexpected Antibodies at a General Hospital in the Daejeon of Korea. Korean J Clin Lab Sci, 50(3): 354–358. https://doi.org/10.15324/kjcls.2018.50.3.354
9. Waggiallah HA, Alenzi FQ, Bin Shaya AS, et al., 2021, The Prevalence of Unexpected Antibodies in Saudi’s Plasma Prior Blood Transfusion and Their Association with Clinical Conditions: A Cross-Sectional Study. Saudi J Biol Sci, 28(8): 4699–4703. https://doi.org/10.1016/j.sjbs.2021.04.083
10. Solanki A, Chandra T, Singh A, 2020, Prevalence of Red Blood Cell Antibodies in Whole Blood Donors: A Single-Centre Experience in North India. Indian J Med Res, 152(3): 280–284. https://doi.org/10.4103/ijmr.IJMR_296_19
11. Chong M, Lee K-T, Cho Y-K, 2017, Survey of Unexpected Antibodies Identified at a General Hospital in Jeju. Korean J Clin Lab Sci, 49(4): 390–394. https://doi.org/10.15324/kjcls.2017.49.4.390
12. Kang H-J, Ihm C-H, Lee M-H, et al., 2010, The Frequency and Distribution of Unexpected Antibodies at a Tertiary Hospital in Daejeon. Korean J Clin Lab Sci, 42(2): 63–70.
13. Kim D-J, Sung H-H, Park C-E, 2016, Investigation of Red Cell Antiobody Screening Tests Gyeonggi Areas. Korean J Clin Lab Sci, 48(2): 36–40.
14. Choi H-K, Choi K-S, 2022, Status of Blood Products Release at a General Hospital in Gyeonggi-Do. Korean J Clin Lab Sci, 54(1): 73–77. https://doi.org/10.15324/kjcls.2022.54.1.73
15. Vescio LAC, Torres OW, Virgilio OS, et al., 1993, Mild Hemolytic Disease of the Newborn Due to Anti-Lewis(a). Vox Sang, 64(3): 194–195.
16. Delk AA, Gammon RR, Alvarez H, et al., 2021, A Hemolytic Transfusion Reaction Caused by an Unexpected Le(b) Antibody. Lab Med, 52(3): 303–306. https://doi.org/10.1093/labmed/lmaa070

Conflict of interest
The authors declare no conflict of interest.
Share
Back to top