Prevalence of Red Blood Cell Alloimmunization among Transfused Chronic Kidney Disease Patients in Hospital Universiti Sains 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....
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doaj-4e92702ba71a4bc6894a3ebdad7dc0142020-11-25T03:55:56ZengOman Medical Specialty BoardOman Medical Journal1999-768X2070-52042020-09-01355e177e17710.5001/omj.2020.95Prevalence of Red Blood Cell Alloimmunization among Transfused Chronic Kidney Disease Patients in Hospital Universiti Sains MalaysiaShafini Mohamed Yusoff0Rosnah Bahar1Mohd Nazri Hassan2Noor Haslina Mohd Noor3Marini Ramli4Nor Fadhilah Shafii5Department of Hematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MalaysiaDepartment of Hematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MalaysiaDepartment of Hematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MalaysiaDepartment of Hematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MalaysiaDepartment of Hematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MalaysiaDepartment of Pathology, Hospital Kuala Krai, Kelantan, MalaysiaObjectives: 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. Methods: We conducted a cross-sectional study over one year from January to December 2018 in the Transfusion Medicine Unit, Hospital Universiti Sains Malaysia. A total of 249 samples were recruited from CKD patients who received a blood transfusion (at least one-pint), which only match for ABO and Rh(D) antigen. The serum was screened for the presence of the RBC antibody using the gel agglutination technique (Diamed gel cards). Samples with positive antibody screening were subjected to antibody identification. Results: Of the 249 transfused CKD patients, 31 (12.4%) developed RBC immunization. Thirty (12%) were alloimmunized, and one (0.4%) was autoimmunized. Anti-Mia was the most common antibody (n = 14, 46.7%) among alloantibodies, followed by anti-E (n = 7, 23.3%). There was a significant association between pregnancy history with the development of antibodies whereas, no significant association was found between sociodemographic background, stage of CKD, hemodialysis status, underlying medical illness, and number of packed cell transfusions with the development of RBC antibodies. Conclusions: One-eighth of our patient cohort had RBC alloimmunization, and the risk was increased in patients with a history of pregnancy. We propose Rhesus RBC phenotyping and to supply blood match Rhesus antigen in CKD patients, especially patients of reproductive age.http://omjournal.org/articleDetails.aspx?coType=1&aId=2750isoantibodiescross-sectional studiesmalaysiablood group antigensblood transfusionerythrocytesrenal insufficiencychronicrenal dialysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shafini Mohamed Yusoff Rosnah Bahar Mohd Nazri Hassan Noor Haslina Mohd Noor Marini Ramli Nor Fadhilah Shafii |
spellingShingle |
Shafini Mohamed Yusoff Rosnah Bahar Mohd Nazri Hassan Noor Haslina Mohd Noor Marini Ramli Nor Fadhilah Shafii Prevalence of Red Blood Cell Alloimmunization among Transfused Chronic Kidney Disease Patients in Hospital Universiti Sains Malaysia Oman Medical Journal isoantibodies cross-sectional studies malaysia blood group antigens blood transfusion erythrocytes renal insufficiency chronic renal dialysis |
author_facet |
Shafini Mohamed Yusoff Rosnah Bahar Mohd Nazri Hassan Noor Haslina Mohd Noor Marini Ramli Nor Fadhilah Shafii |
author_sort |
Shafini Mohamed Yusoff |
title |
Prevalence of Red Blood Cell Alloimmunization among Transfused Chronic Kidney Disease Patients in Hospital Universiti Sains Malaysia |
title_short |
Prevalence of Red Blood Cell Alloimmunization among Transfused Chronic Kidney Disease Patients in Hospital Universiti Sains Malaysia |
title_full |
Prevalence of Red Blood Cell Alloimmunization among Transfused Chronic Kidney Disease Patients in Hospital Universiti Sains Malaysia |
title_fullStr |
Prevalence of Red Blood Cell Alloimmunization among Transfused Chronic Kidney Disease Patients in Hospital Universiti Sains Malaysia |
title_full_unstemmed |
Prevalence of Red Blood Cell Alloimmunization among Transfused Chronic Kidney Disease Patients in Hospital Universiti Sains Malaysia |
title_sort |
prevalence of red blood cell alloimmunization among transfused chronic kidney disease patients in hospital universiti sains malaysia |
publisher |
Oman Medical Specialty Board |
series |
Oman Medical Journal |
issn |
1999-768X 2070-5204 |
publishDate |
2020-09-01 |
description |
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. Methods: We conducted a cross-sectional study over one year from January to December 2018 in the Transfusion Medicine Unit, Hospital Universiti Sains Malaysia. A total of 249 samples were recruited from CKD patients who received a blood transfusion (at least one-pint), which only match for ABO and Rh(D) antigen. The serum was screened for the presence of the RBC antibody using the gel agglutination technique (Diamed gel cards). Samples with positive antibody screening were subjected to antibody identification. Results: Of the 249 transfused CKD patients, 31 (12.4%) developed RBC immunization. Thirty (12%) were alloimmunized, and one (0.4%) was autoimmunized. Anti-Mia was the most common antibody (n = 14, 46.7%) among alloantibodies, followed by anti-E (n = 7, 23.3%). There was a significant association between pregnancy history with the development of antibodies whereas, no significant association was found between sociodemographic background, stage of CKD, hemodialysis status, underlying medical illness, and number of packed cell transfusions with the development of RBC antibodies. Conclusions: One-eighth of our patient cohort had RBC alloimmunization, and the risk was increased in patients with a history of pregnancy. We propose Rhesus RBC phenotyping and to supply blood match Rhesus antigen in CKD patients, especially patients of reproductive age. |
topic |
isoantibodies cross-sectional studies malaysia blood group antigens blood transfusion erythrocytes renal insufficiency chronic renal dialysis |
url |
http://omjournal.org/articleDetails.aspx?coType=1&aId=2750 |
work_keys_str_mv |
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