An update on the JR blood group system.
CONCLUSIONS: This update of the JR blood group system (Castilho L, Reid MR. A review of the JR blood group system. Immunohematology 2013;29:63-8) reports new ABCG2 alleles encoding Jr(a-) and Jr(a+w/-) phenotypes, the predominant alleles encoding the Jr(a-) phenotype, and new functional aspects of the ABCG2 glycoprotein. The JR blood group system (International Society of Blood Transfusion system 32) consists of one antigen: Jra. PMID: 31246485 [PubMed - in process] (Source: Immunohematology)
Source: Immunohematology - June 29, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Heat elution: a modification of the Landsteiner-Miller method.
CONCLUSIONS: Elution removes antibodies coating red blood cells and allows for serologic testing of the recovered antibodies. Heat elution may be used in the investigation of ABO hemolytic disease of the fetus and newborn, in the detection of weak A and B antigens in combination with adsorption-elution using polyclonal antibodies, and for the resolution of interfering IgM agglutinating antibodies. PMID: 31246486 [PubMed - in process] (Source: Immunohematology)
Source: Immunohematology - June 29, 2019 Category: Hematology Tags: Immunohematology Source Type: research

An update on the Scianna blood group system.
CONCLUSIONS: This update of the Scianna blood group system (Brunker PA, Flegel WA. Scianna: the lucky 13th blood group system. Immunohematology 2011;27:41-57) provides the recent work on the genetic variation of ERMAP across more world populations, the elucidation of the molecular basis of an historical serologic case, new cases of antibodies in the system, the development of new serologic reagents, and new discoveries in the biology of the erythroid membrane associated protein (ERMAP). Although genetic variation in ERMAP has been extensively cataloged, nonsynonymous variants associated with alloantigens have remained limi...
Source: Immunohematology - June 29, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Rh immune globulin: an interfering substance in compatibility testing.
CONCLUSIONS: Immunoglobulin therapy that interferes with pretransfusion testing may complicate the interpretation of test results and adversely affect patient management. Rh immune globulin (RhIG) should be considered an interfering immunoglobulin therapy when it is detected in an antibody detection test of a sample from a patient who has been treated with RhIG. Frequently, detection occurs in mother's or newborn's plasma. Because an antenatal injection of RhIG is indicated for pregnant Rh-negative women, anti-D is detected frequently by today's highly sensitive antibody screen methods when the mother's plasma is tested su...
Source: Immunohematology - June 29, 2019 Category: Hematology Tags: Immunohematology Source Type: research

An update on the MNS blood group system.
CONCLUSIONS: This update of the MNS blood group system (Reid ME. MNS blood group system: a review. Immunohematology 2009;25:95-101) reports three new antigens of the MNS system numbered MNS47, MNS48, and MNS49; new glycophorin (GP) variants associated with silent and weak expression of MNS antigens; and the results of new studies on associations of MNS antigens with band 3, Rh proteins, and malaria. The addition of these three antigens brings the total number of antigens in the MNS system (International Society of Blood Transfusion system 2) to 49. PMID: 31246489 [PubMed - in process] (Source: Immunohematology)
Source: Immunohematology - June 29, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Albumin-indirect antiglobulin test.
CONCLUSIONS: Albumin was the first widely used additive solution for hemagglutination tests. Its major effect is to decrease the repulsive forces that keep red blood cells (RBCs) apart. This effect may enable some RBC antibodies, particularly those in the Rh blood group system, to directly agglutinate antigen-positive RBCs after 37°C incubation. The impact of albumin on antibody binding before detection by an indirect antiglobulin test (IAT) is minimal. Use of albumin in antibody identification may help with separation of RBC antibody specificities in a mixture when one or more antibodies demonstrate reactivity after 3...
Source: Immunohematology - June 29, 2019 Category: Hematology Tags: Immunohematology Source Type: research

An update on the Lewis blood group system.
CONCLUSIONS: This update of the Lewis blood group system (Combs MR. Lewis blood group system review. Immunohematology 2009;25:112-8) describes new information on the clinical significance of Lewis antigens regarding susceptibility of individuals to certain diseases and the possible role of bacteria in Lewis expression. This update also describes recently reported examples of Lewis antibodies causing hemolytic transfusion reactions. No new antigens have been identified in the International Society of Blood Transfusion system 7, leaving the antigen count to stand at six: Lea, Leb, LebH, ALeb, BLeb, and Leab. PMID: 312464...
Source: Immunohematology - June 29, 2019 Category: Hematology Tags: Immunohematology Source Type: research

An update on the H blood group system.
CONCLUSIONS: This update of the H blood group system (Scharberg EA, Olsen C, Bugert P. The H blood group system. Immunohematology 2016;32:112-8) reports 11 new FUT1 null alleles: 8 causative for the H- phenotype (Bombay phenotype, Oh), 3 in para-Bombay cases, and 5 new FUT1 alleles causative for a weak H phenotype (para-Bombay, H+w). The H blood group system (International Society of Blood Transfusion system 18) consists of a single antigen (H) defined by a terminal fucose residue found on red blood cells (RBCs) and in secretions. The H antigen is synthesized on the RBC surface by the FUT1 gene product fucosyltransferase 1...
Source: Immunohematology - June 29, 2019 Category: Hematology Tags: Immunohematology Source Type: research

An update on the Augustine blood group system.
CONCLUSIONS: This update of the Augustine (AUG) blood group system (Daniels G. The Augustine blood group system, 48 years in the making. Immunohematology 2016;32:100-3) describes two antigens that have been added to the Augustine system (International Society of Blood Transfusion system 36), bringing the number of antigens in the system to four. Further information on the clinical significance of Augustine system antibodies and the function of the Augustine glycoprotein, equilibrative nucleoside transporter 1, is presented. PMID: 30908068 [PubMed - in process] (Source: Immunohematology)
Source: Immunohematology - March 27, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Donath-Landsteiner test.
CONCLUSIONS: The Donath-Landsteiner (DL) test is a serologic test used to detect the presence of a biphasic hemolysin. This autoantibody is seen in patients with paroxysmal cold hemoglobinuria. The test relies on the characteristic cold binding of an IgG autoantibody with specificity to the P blood group antigen. This autoantibody causes complement-mediated red blood cell (RBC) lysis when warmed to body temperature. In this review, we describe the various methods for performing the DL test-namely a direct test, an indirect test, an indirect test with modifications such as the use of enzyme-treated RBCs and two stages, and ...
Source: Immunohematology - March 27, 2019 Category: Hematology Tags: Immunohematology Source Type: research

An update on the CD59 blood group system.
CONCLUSIONS: This update of the CD59 blood group system (Weinstock C, Anliker M, von Zabern I. CD59: a long-known complement inhibitor has advanced to a blood group system. Immunohematology 2015;31:145-51) increases the number of reported patients with CD59 deficiency from 10 to 14. All of these 14 patients suffered from severe illness. Recently, a new variant allele was found in heterozygosity. Flow cytometry data suggest that this variant was expressed on the red blood cells of the propositus. Although additional alleles have been found, the CD59 system (International Society of Blood Transfusion system 35) continues to ...
Source: Immunohematology - March 27, 2019 Category: Hematology Tags: Immunohematology Source Type: research

ZZAP treatment of red blood cells.
CONCLUSIONS: ZZAP is a mixture of a sulfhydryl reagent (dithiothreitol) and a proteolytic enzyme (papain or ficin). This reagent dissociates IgG and complement from red blood cells, allowing for phenotyping, enhanced adsorption, or denaturing of multiple blood group system antigens to aid in completing complex antibody workups. ZZAP treatment destroys all antigens in the Kell, Landsteiner- Wiener, Cartwright, Dombrock, and Knops blood group systems as well as antigens destroyed by proteases (e.g., M, N, S, Fya, and Fyb). PMID: 30908071 [PubMed - in process] (Source: Immunohematology)
Source: Immunohematology - March 27, 2019 Category: Hematology Tags: Immunohematology Source Type: research

An update on the Duffy blood group system.
CONCLUSIONS: This update of the Duffy (FY) blood group system (Meny GM. The Duffy blood group system: a review. Immunohematology 2010;26:51-6) includes additional variants to the Duffy system (International Society of Blood Transfusion system 8; five anti-gens) identified through molecular studies. The most interesting clinical updates, however, include further evaluation of the roles of the Duffy glycoprotein, also known as the atypical chemokine receptor 1, in malaria and hematopoiesis. The transition to understanding the important role of blood group antigens in homeostasis and disease continues. PMID: 30908072 [Pub...
Source: Immunohematology - March 27, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Serologic problems associated with administration of intravenous immune globulin (IVIg).
CONCLUSIONS: Intravenous immune globulin (IVIg) is manufactured from large pools of donor plasma and contains a high diversity of antibodies, primarily IgG. For this reason, IVIg is routinely used as antibody replacement therapy for patients having primary immunodeficiencies. In 1981, IVIg was also found to be a strong immunomodulator of various inflammatory and autoimmune conditions. This observation has led to the exponential increase in the use of IVIg throughout the world, with the United States and Canada being the biggest users of IVIg. Although relatively rare, adverse events, such as hemolytic anemia and thrombosis...
Source: Immunohematology - March 27, 2019 Category: Hematology Tags: Immunohematology Source Type: research

An update on the Knops blood group system.
CONCLUSIONS: This update of the Knops (KN) blood group system (Moulds JM. The Knops blood group system. Immunohematology 2010;26:2-7) adds no new antigens to this system (International Society of Blood Transfusion system 22), which currently has nine antigens. However, the molecular basis of York, KN5, or Yka has been identified as c.4223C>T and designated KN*01.-05. Although not considered clinically significant in the field of transfusion medicine, there has been great interest in the Knops polymorphism by investigators working on malaria documented by numerous studies over the past 8 years. PMID: 30908074 [PubMed...
Source: Immunohematology - March 27, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Inhibition of blood group antibodies by soluble substances.
CONCLUSIONS: The presence of multiple alloantibodies or an antibody to a highprevalance antigen in a patient sample can pose challenges in antibody identification. The pattern of reactivity seen on an antibody panel may show various strengths of reactivity by different methods of testing or same strength of reactivity at one or more phases of testing. To ensure proper identification, multiple investigative tools may be used. We review one of these methods-inhibition by soluble substances-which has become an expansion of our toolbox within the past 10 years. Alloantibodies can be inhibited using specific soluble substances....
Source: Immunohematology - March 27, 2019 Category: Hematology Tags: Immunohematology Source Type: research

An update on the Lutheran blood group system.
CONCLUSIONS: This update of the Lutheran (LU) blood group system (Daniels G. Lutheran. Immunohematology 2009;25:152-9) describes six new antigens of the Lutheran system (International Society of Blood Transfusion system 5). These antigens are numbered LU22 to LU27, resulting in a total of 25 antigens in the system. The molecular background of LU7 is also described. New KLF1 mutations responsible for In(Lu) have been identified, and the gene responsible for the X-linked form of Lumod has been identified. PMID: 30908076 [PubMed - in process] (Source: Immunohematology)
Source: Immunohematology - March 27, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Sulfhydryl treatment of serum or plasma for the reduction of IgM antibodies.
CONCLUSIONS: Dithiothreitol (DTT) and 2-mercaptoethanol (2-ME) are sulfhydryl compounds that can be used to treat serum or plasma to denature IgM antibody reactivity. By using sulfhydryl agents, IgG and IgM antibodies can be separated, the relative amount of IgM and IgG antibodies can be determined, and the risk of hemolytic disease of the fetus and newborn can be assessed. PMID: 30624946 [PubMed - in process] (Source: Immunohematology)
Source: Immunohematology - January 10, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Validity and reliability of serologic immunophenotyping of multiple blood group systems by ORTHO Sera with fully automated procedure.
CONCLUSIONS: The increase of immunization against blood group antigens has reinforced the need for automated extensive blood typing. The aim of this study was to assess both the validity and reliability of red blood cell (RBC) automated agglutination technology in testing for antigens of Kidd (Jk), Duffy (Fy), and MNS (Ss) blood systems. ORTHO Sera (Ortho Clinical Diagnostics, Raritan, NJ) anti-Jka, anti-Jkb, Anti-Fya, anti-Fyb, anti-S, and anti-s reagents were each tested on RBC samples previously typed. Replicates were performed on three separate testing sessions with three consecutive repetitions within each session, th...
Source: Immunohematology - January 10, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Use of the prewarm method for detecting clinically significant alloantibodies in the presence of cold autoantibodies.
CONCLUSIONS: The prewarm (PW) method is useful for detecting and identifying clinically significant antibodies that bind to red blood cells and complement at 37°C and for avoiding antibodies that bind at temperatures less than 37°C. Antibodies that bind at temperatures less than 37°C are often cold autoantibodies that may be present in the serum of healthy individuals and are usually not clinically significant. The PW method is useful when these cold autoantibodies have a wide thermal range and interfere with standard testing methods by reacting at the 37°C and antihuman globulin test phases. When using the...
Source: Immunohematology - January 10, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Blood chimerism in twins.
CONCLUSIONS: Chimerism is a phenomenon in which an individual has cells with different genetic content from different zygotes. In dizygotic twins (DTs), chimerism is believed to occur through placental anastomoses that enable the bidirectional exchange of hematopoietic stem cells. Little is still known about chimerism frequency in twins, but several studies have shown a relation between chimerism and some conditions such as autism, Alzheimer's disease, and a group of autoimmune diseases such as Sjögren syndrome, systemic lupus erythematosus, and systemic sclerosis. In addition to chimerism of ABO blood groups being po...
Source: Immunohematology - January 10, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Cold autoadsorption.
CONCLUSIONS: Cold-reactive autoantibodies can mask the presence of underlying clinically significant alloantibodies in a patient's plasma or serum. These autoantibodies are problematic when performing laboratory procedures such as ABO typing, red blood cell (RBC) crossmatching, antibody detection testing, and antibody identification. To avert the masking of clinically significant alloantibodies in a patient's plasma or serum, adsorption studies can be performed at 4°C using autologous RBCs if the patient has not been recently transfused. PMID: 30624950 [PubMed - in process] (Source: Immunohematology)
Source: Immunohematology - January 10, 2019 Category: Hematology Tags: Immunohematology Source Type: research

An update on the GLOB blood group system (and former GLOB collection).
CONCLUSIONS: The main change that has occurred in the GLOB blood group system since the GLOB review published in this journal in 2013 is the addition of an antigen. The high-prevalence PX2 antigen, originally recognized as the x2 glycosphingolipid, is expressed on red blood cells of most individuals and is elevated in the rare PP1Pk-negative p blood group phenotype. P synthase, encoded by B3GALNT1, was found to elongate paragloboside to PX2 by adding the terminal β3GalNAc moiety. Hence, PX2 was moved from the GLOB collection to the GLOB system. The presence of naturally-occurring anti-PX2 was noted in P1k and P2k indi...
Source: Immunohematology - January 10, 2019 Category: Hematology Tags: Immunohematology Source Type: research

Clinical significance of antibodies to antigens in the Raph, John Milton Hagen, I, Globoside, Gill, Rh-associated glycoprotein, FORS, JR, LAN, Vel, CD59, and Augustine blood group systems.
CONCLUSIONS: This article reviews information on the clinical significance of antibodies to antigens in the Raph, John Milton Hagen, I, Globoside, Gill, Rh-associated glycoprotein, FORS, JR, LAN, Vel, CD59, and Augustine blood group systems. Antibodies to many of the antigens in these groups are rarely encountered because of the high prevalence of the associated antigens in most populations. For many of these antibodies, the clinical significance-that is, the potential to cause reduced survival of transfused antigen-positive red blood cells or a transfusion reaction (e.g., anti-P, anti-Jra, and anti-Lan), and/or hemolytic ...
Source: Immunohematology - October 10, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Rouleaux and saline replacement.
CONCLUSIONS: Rouleaux is a phenomenon that commonly occurs in patients who have an increased number of circulating protein macromolecules. It is a benign, in vitro reaction that appears microscopically as red blood cells (RBCs) line up against each other; many liken the RBC aggregation to "stacked coins." This unexpected reactivity may cause confusion in direct agglutination testing such as reverse blood typing and crossmatching. Saline replacement is the established method to resolve rouleaux. True agglutination will remain when plasma is replaced with saline for resuspension of the RBC button. Rouleaux will no ...
Source: Immunohematology - October 10, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Method-specific and unexplained reactivity in automated solid-phase testing and their association with specific antibodies.
CONCLUSIONS: The inherent tradeoff between sensitivity and specificity in the detection of unexplained antibodies has been the objective of many studies, editorials, and journal articles. Many publications note that no method is capable of detecting all clinically significant antibodies while avoiding all clinically insignificant antibodies. This study describes the frequency of nonspecific reactivity and unexplained reactivity in solid-phase testing, along with the subsequent development of specific antibodies (Abs). In this study, nonspecific reactivity (NS) is defined as method-specific panreactivity detected by solid-p...
Source: Immunohematology - October 10, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Utility of chloroquine diphosphate in the blood bank laboratory.
CONCLUSIONS: Chloroquine diphosphate (CDP) is a helpful tool in the blood bank for two main applications. The most common application is to render direct antiglobulin test-positive red blood cells (RBCs) free from membrane-bound IgG; these treated RBCs can then be used for autologous adsorption and/or to determine the patient's RBC phenotype. Another common use of CDP is to remove human leukocyte antigens (HLAs) from RBCs to help identify or exclude the presence of antibodies to HLAs expressed on RBCs, for example, Bennett-Goodspeed (Bg) antigens. In this review, the principles, applications, and limitations of using CDP a...
Source: Immunohematology - October 10, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Clinical significance of antibodies to antigens in the Scianna, Dombrock, Colton, Landsteiner-Weiner, Chido/Rodgers, H, Kx, Cromer, Gerbich, Knops, Indian, and Ok blood group systems.
CONCLUSIONS: This article reviews information regarding the clinical significance of antibodies to antigens in the Scianna, Dombrock, Colton, Landsteiner-Wiener, Chido/Rodgers, H, Kx, Cromer, Gerbich, Knops, Indian, and Ok blood group systems. Like most blood group systems, antibodies to many of the antigens in these groups are rarely encountered because of the high prevalence of the associated antigens in most populations. For many, the clinical significance-that is, the potential to cause reduced survival of transfused antigen-positive red blood cells or a transfusion reaction (e.g., anti-Ge2, anti-H) and/or hemolytic di...
Source: Immunohematology - October 10, 2018 Category: Hematology Tags: Immunohematology Source Type: research

A delayed and acute hemolytic transfusion reaction mediated by anti-c in a patient with variant RH alleles.
CONCLUSIONS: The Rh system is the most complex of the human blood groups. Of the 55 antigens that have been characterized, the system's principal antigens D, C, E, c, and e are responsible for the majority of clinically significant Rh antibodies. In the last few years, advancements in molecular testing have provided a wealth of information on the genetic diversity of the Rh locus. This case report describes a patient with variant RHD*DAR alleles inherited in conjunction with two compound heterozygote RHCE*ceEK/RHCE*ceAR alleles. The patient was previously alloimmunized to D, C, and E and possibly hrS. Further transfusion o...
Source: Immunohematology - October 10, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Detecting polyagglutinable red blood cells.
CONCLUSIONS: Polyagglutination is a condition in which red blood cells (RBCs) are agglutinated by normal adult human sera but not by autologous or newborn sera. Polyagglutination is caused by changes in the RBC membrane that enable patient RBCs to agglutinate with normal human sera; this agglutination can interfere with blood bank testing. Depending on the cause, polyagglutination may or may not be the cause of RBC hemolysis. Lectins and human sera can be used to detect polyagglutinable RBCs. Identification of this phenomenon can be helpful in providing not only transfusion recommendation information for physicians but als...
Source: Immunohematology - October 10, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Clinical significance of antibodies to antigens in the International Society of Blood Transfusion collections, 700 series of low-incidence antigens, and 901 series of high-incidence antigens.
CONCLUSIONS: This article reviews information regarding the clinical significance of antibodies to antigens in the blood group collections, the 700 series of low-incidence antigens, and the 901 series of high-incidence antigens. Antibodies to many of the antigens in these groups are rarely encountered, meaning that available information is limited. For a few, the clinical significance-the potential to cause reduced survival of transfused antigen-positive red blood cells, a hemolytic transfusion reaction (e.g., anti-AnWj, anti-Emm), or hemolytic disease of the fetus and newborn (e.g., anti-Kg, anti-HJK)-has been documented....
Source: Immunohematology - July 12, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Adsorption of cold agglutinins with rabbit red blood cells.
CONCLUSIONS: Cold-reactive autoagglutinins may mask the presence of underlying clinically significant alloantibodies. Adsorption with rabbit red blood cells (RBCs) or stroma can remove cold autoagglutinins found in the patient's plasma/serum that are directed towards antigens expressed on the surface of rabbit RBCs. By removing these cold autoagglutinins, it is then possible to determine whether any underlying alloantibody reactivity is present. Although this method may also unintentionally adsorb alloantibodies directed towards antigens found on rabbit RBCs, it is still a widely used and convenient method to remove cold a...
Source: Immunohematology - July 12, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Mixed-field agglutination observed in column agglutination testing is not always associated with the A3 subgroup.
CONCLUSIONS: Mixed-field agglutination (MFA) can be observed in forward typing of samples from A3 individuals with serologic ABO typing methods. The results of column agglutination testing (CAT) and tube agglutination testing using different antibody clones can be discordant. In this report, we reveal our experience using polymerase chain reaction-sequence-based typing (PCR-SBT) of ABO exon 7 to clarify serologic method discordance of A subgroup blood typing in Northern Thai donors. A total of 21 group A blood donors with either MFA or weak agglutination on routine ABO CAT were recalled. CAT was repeated with human and mon...
Source: Immunohematology - July 12, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Low-ionic-strength saline solution-antiglobulin test (LISS-AGT).
CONCLUSIONS: The use of low-ionic-strength saline (LISS) solution as an enhancement for antibody screening and crossmatching was first described by Löw and Messeter in 1974. This method allowed for a reduced incubation time while maintaining adequate specificity and sensitivity of the antiglobulin test (AGT). Since then, the LISS-AGT tube method has been widely used in antibody detection and identification, as well as compatibility testing. As initially described, the method used red blood cells suspended in LISS. Modifications of the method led to development of the commercially prepared LISS additive solutions in us...
Source: Immunohematology - July 12, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Rh and Kell blood group antigen prevalence in a multi-ethnic cohort in Nigeria: implications for local transfusion service.
CONCLUSIONS: Antigens belonging to the Rh and Kell blood group systems are of major clinical significance because of their immunogenicity and the potential of their consequent antibodies to cause in vivo destruction of exogenous red blood cells (RBCs). Despite the wide-spread use of transfusion, there are sparse data on the prevalence of Rh and Kell system antigens and their ethnic variability in Nigeria. The objective of this study was to determine the prevalence of the five major Rh (D, C, c, E, e) and Kell (K) system antigens in Nigeria with the goal of understanding alloimmunization risk in transfusion recipients and i...
Source: Immunohematology - July 12, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Clinically significant naturally occurring anti-N and anti-S in a blood donor: a rare finding.
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. We report a case of naturally occurring alloanti-N and alloanti-S in a healthy D+ blood donor. Both antibodies were reactive over a wide thermal...
Source: Immunohematology - July 12, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Warm autoadsorption using ZZAP.
CONCLUSIONS: The masking of clinically significant alloantibodies by warm autoantibodies presents challenges in pretransfusion testing. The adoption of transfusion practices such as the issuing of "least incompatible" red blood cells (RBCs) without a complete antibody workup is potentially unsafe for patients. Several autoadsorption methods can be used to remove autoantibody reactivity. ZZAP treatment of autologous RBCs is an efficient way to prepare the cells for autoadsorption. Autoadsorbed serum or plasma can then be used to remove autoantibody reactivity and identify clinically significant alloantibodies. ...
Source: Immunohematology - April 3, 2018 Category: Hematology Tags: Immunohematology Source Type: research

A brief overview of clinical significance of blood group antibodies.
CONCLUSIONS: This review was derived from a presentation made on September 2, 2016 for the first Academy Day presented by the Working Party on Immunohematology at the International Society of Blood Transfusion (ISBT) Congress in Dubai. The focus of this review is to provide a brief overview of the clinical significance of blood group antibodies. Blood group antibodies can be naturally occurring (e.g., anti-A and anti-B through exposure to naturally occurring red blood cell [RBC] antigen-like substances) or can occur via exposure to foreign (donor) RBC antigens through previous transfusions, transplants, or exposure to feta...
Source: Immunohematology - April 3, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Management of pregnancy sensitized with anti-Inb with monocyte monolayer assay and maternal blood donation.
CONCLUSIONS: Maternal red blood cell (RBC) alloantibodies can cause hemolytic disease of the fetus and newborn (HDFN). Although much is described about common antibodies associated with HDFN, management of a pregnancy complicated by a maternal rare antibody presents several challenges related to assessment of fetal anemia risk, availability of blood for transfusion to the mother and/or the fetus or newborn if needed, and planning for delivery in the case of maternal hemorrhage. Here we report the laboratory medicine workup of a patient who presented for obstetrical care in the United States in the third trimester and had a...
Source: Immunohematology - April 3, 2018 Category: Hematology Tags: Immunohematology Source Type: research

A review of in vitro methods to predict the clinical significance of red blood cell alloantibodies.
CONCLUSIONS: This review was derived from a presentation made on September 2, 2016, for the first Academy Day presented by the Working Party on Immunohematology at the International Society of Blood Transfusion (ISBT) Congress in Dubai. The focus of this review is on the clinical significance of alloimmunization in transfusion-specifically, the parameters that contribute to a clinically significant alloantibody. The areas of focus were as follows: Introduction, Technical Aspects, and Indications and Limitations. Each section contains a brief review of selected literature and experiential knowledge. Case reports are needed ...
Source: Immunohematology - April 3, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Recovery of autologous sickle cells by hypotonic wash.
CONCLUSIONS: It is important to isolate autologous red blood cells (RBCs) from transfused RBCs in samples from recently transfused patients to ensure that accurate serologic results are obtained. Typically, this isolation can be performed using methods that separate patient reticulocytes from transfused, older donor RBCs. Patients with sickle cell disease (SCD), however, characteristically have RBCs with altered membrane and morphological features, causing their RBCs to take on a sickle-shape appearance different from the biconcave disc-shape appearance of "normal" RBCs. These characteristics enable the use of hy...
Source: Immunohematology - April 3, 2018 Category: Hematology Tags: Immunohematology Source Type: research

The devil is in the details: retention of recipient group A type 5 years after a successful allogeneic bone marrow transplant from a group O donor.
CONCLUSIONS: ABO-incompatible (ABOi) hematopoietic stem cell transplants (HSCTs) can present challenges in the blood bank. During transplantation, patients receive components that are ABO-compatible with both the donor graft and recipient; this practice can strain group O red blood cell (RBC) inventories.1 In addition, there are risks for acute hemolysis at the time of infusion and in the early post-transplant period.1,2 In ABO major-incompatible bone marrow HSCTs, which contain significant quantities of donor RBCs that are ABOi with recipient plasma, it is common to perform a RBC depletion of the bone marrow in an effort ...
Source: Immunohematology - April 3, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Assessment of common red blood cell pretreatments to yield an accurate serologic antigen phenotype compared with genotypepredicted phenotype.
CONCLUSIONS: For patients requiring multiple transfusions and patients with positive direct antiglobulin tests (DATs), an extended red blood cell (RBC) phenotype can provide valuable information and help to determine the risk of forming alloantibodies. In some instances, the phenotype may be used for prophylactic matching. Phenotyping in this patient population is often hindered by the presence of circulating donor cells and/or by a positive DAT. Several methods, such as EDTA glycine acid (EGA) treatment to remove IgG, hypotonic saline wash to separate autologous RBCs, or reticulocyte separation, are often used in these si...
Source: Immunohematology - January 30, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Anti-Vel alloimmunization and severe hemolytic disease of the fetus and newborn.
CONCLUSIONS: Only rare cases of anti-Vel-associated mild-to-moderate hemolytic disease of the fetus and newborn have been previously reported. No case of fetal anemia requiring prenatal therapy has been noted to date. We report such a case recently encountered at our Fetal Center. Strategies are discussed for managing pregnancy complicated with alloimmunization to an antibody to a high-prevalence antigen, including sources of red blood cells for intrauterine transfusions. PMID: 29378146 [PubMed - in process] (Source: Immunohematology)
Source: Immunohematology - January 30, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Separation of multiple antibodies by adsorption with allogeneic red blood cells.
CONCLUSIONS: Antibody detection and identification are processes that are commonly performed in the transfusion service before transfusion of allogeneic red blood cells (RBCs). Antibody identification usually follows the discovery of a positive antibody detection test, or other factors such as ABO serum/cell discrepancy or an incompatible crossmatch. Antibody identification is a necessary practice in blood banking to determine the suitability of blood products for transfusion on an individual basis. When the presence of multiple antibodies is suspected, several methods, including neutralization of patient's plasma, titrati...
Source: Immunohematology - January 30, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Hemovigilance and the Notify Library.
CONCLUSIONS: Hemovigilance systems allow reporting of adverse occurrences associated with blood transfusion to a central database where events can be reviewed and analyzed for the benefit of patients and donors. Hemolytic and serologic transfusion reactions are among the many types of reactions reported to these systems. The Notify Library, a database of adverse events associated with medical products of human origin, has incorporated hemovigilance into its didactic resources. Students and practitioners are encouraged to use the electronic library and to further enhance this resource through review and recommendation of ad...
Source: Immunohematology - January 30, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Clinical and laboratory profile of anti-M.
CONCLUSIONS: Anti-M is a frequently detected naturally occurring antibody that has been reported in various clinical settings and also in voluntary donors. We describe here the clinical and laboratory findings of 11 cases with anti-M detected at our center. This report is a retrospective study in which we reviewed our immunohematology laboratory records for cases involving anti-M. Both donor and patient data from a 28-month period (September 2014 to December 2016) were reviewed. During this period, 11 examples of anti-M were detected (8 patients, 1 voluntary whole blood donor, and 1 hematopoietic stem cell donor. Anti-M wa...
Source: Immunohematology - January 30, 2018 Category: Hematology Tags: Immunohematology Source Type: research

Dithiothreitol treatment of red blood cells.
CONCLUSIONS: Dithiothreitol (DTT), a reducing reagent, has multiple applications in blood bank testing. DTT disrupts the bridging of the disulfide bonds between amino acid residues necessary for structural conformation of some proteins and the bonds holding an IgM molecule in the pentameric formation. DTT treatment of red blood cells (RBCs) can denature or modify certain blood group antigens-in particular, those in the Kell, Lutheran, YT, JMH, LW, Cromer, Indian, Dombrock, and Knops systems-and prevent recognition by the corresponding antibodies. It also destroys RBC CD38, allowing DTT-treated RBCs to be used to avoid test...
Source: Immunohematology - January 30, 2018 Category: Hematology Tags: Immunohematology Source Type: research

ABO serology in a case of persistent weak A in a recipient following a group O-matched unrelated bone marrow transplant.
CONCLUSIONS: HLA-matched hematopoietic stem cell transplantation (HSCT) from red blood cell (RBC)-incompatible donors is not uncommon. The engraftment process following ABO-incompatible allogeneic HSCT results in the transition from patient blood group to donor blood group in the recipient. In contrast, most non-hematopoietic tissues retain expression of the patient's original blood group for life, and these antigens may adsorb from the plasma onto the donor-derived RBCs. Correct serologic interpretation of the ABO blood group during this engraftment process can be difficult. We present the serologic findings of a 15-year-...
Source: Immunohematology - October 20, 2017 Category: Hematology Tags: Immunohematology Source Type: research

Stability guidelines for dithiothreitol-treated red blood cell reagents used for antibody detection methods in patients treated with daratumumab.
CONCLUSIONS: Daratumumab (DARA), a drug used to treat patients with multiple myeloma, causes interference in pre-transfusion testing. Samples from patients receiving DARA exhibit panreactivity in antibody detection and identification tests with red blood cells (RBCs). Many hospitals are sending these samples to reference laboratories. Dithiothreitol (DTT), a sulfhydryl chemical treatment of RBCs, negates this reactivity. This study investigated the stability of the antigens on DTT-treated RBCs to determine if large quantities of RBCs could be treated at one time, stored, and used for testing at a later time. Panel cells we...
Source: Immunohematology - October 20, 2017 Category: Hematology Tags: Immunohematology Source Type: research