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Case report | 16-May-2020

Case report: exacerbation of hemolytic anemia requiring multiple incompatible RBC transfusions

RBC transfusions in a patient with a history of autoimmune hemolytic anemia (AIHA) can represent both a laboratory and a clinical challenge. The development of high-titer low-avidity antibodies and antibodies to high-frequency antigens may further impair the ability to identify compatible donor RBCs. Not infrequently, incompatible RBCs must be used and the desire to increase oxygen carrying capacity conflicts with the desire to avoid exacerbating the autoimmune hemolytic process with RBC

Annika M. Svensson, Sharon Bushor, Mark K. Fung

Immunohematology, Volume 20 , ISSUE 3, 177–183

Article | 22-January-2021

Freezing and recovering rare red blood cells using glycerol

Principle According to the AABB Standards for Immunohematology Reference Laboratories, an accredited immunohematology reference laboratory (IRL) must maintain an appropriate inventory of reagent red blood cells (RBCs) for testing. This inventory should include RBCs negative for high-prevalence antigens, such as Kpb, Jsb, and Vel, as well as rare phenotypes, such as PP1Pk, Rhnull, and Kiddnull, which are not readily available in commercial panel cells.1 When such rare RBC phenotypes are

B. Eades

Immunohematology, Volume 36 , ISSUE 3, 85–88

Case report | 16-March-2020

Autoantibody formation after alloimmunization inducing bystander immune hemolysis

The development of RBC autoantibodies resulting from or associated with allogeneic blood transfusions is not an easily determined complication of RBC transfusions. This report discusses one patient who developed RBC autoantibodies in association with an allogeneic blood transfusion and alloimmunization leading to a temporary bystander immune hemolysis. A 72-year-old woman was hospitalized as a result of severe anemia and received two units of ABO- and D-compatible RBCs. She had a history of two

Mariza Mota, C. Bley, M.G. Aravechia, N. Hamerschlak, A. Sakashita, J.M. Kutner, L. Castilho

Immunohematology, Volume 25 , ISSUE 1, 9–12

Report | 01-December-2019

Red blood cell phenotyping after transfusion: an in vitro model

Recipient red blood cell (RBC) phenotyping using serologic techniques, within 3 months of a transfusion, is considered unreliable. We conducted in vitro experiments to determine how long recipient RBC phenotyping results would be compromised after an allogeneic transfusion. In vitro models were created to mimic in vivo posttransfusion ratios of “transfused” RBCs with either a single or a double dose of an antigen and “autologous” RBCs negative for the corresponding

Kumudini Gonsalkorale, Charlotte Vanhecke, Krishna G. Badami

Immunohematology, Volume 29 , ISSUE 3, 93–96

Article | 14-October-2020

Enzyme and DTT treatment of adherent RBCs for antibody identification by a solid phase immunoassay system

Treatment of RBCs with protease enzymes or dithiothreitol (DTT) causes denaturation of several RBC antigens and is regularly used in antibody identification. In this study, we have standardized enzyme and DTT treatment of adherent RBCs in the magnetic-mixed passive hemagglutination assay (M-MPHA) for antibody identification. We have also tried drying these treated RBCs. The optimal enzyme and DTT treatment conditions for intact adherent RBCs were determined, in addition to the optimal condition

Toyohiro Tamai, Toshio Mazda

Immunohematology, Volume 18 , ISSUE 4, 114–119

Report | 16-March-2020

Transfusion of rare cryopreserved red blood cell units stored at -80°C: the French experience

The technology allowing freezing of RBC units has been available for many decades. The high-glycerol method for RBC storage at –80°C is predominantly used. Several studies have shown satisfactory results regarding the in vitro viability and function of cryopreserved RBCs. RBC freezing is nowadays mostly encountered in rare blood programs and military deployments. Preservation time of frozen RBCs appears to be virtually indefinite, but most countries apply a 10-year outdate. There is

Thierry Peyrard, Bach-Nga Pham, Pierre-Yves Le Pennec, Philippe Rouger

Immunohematology, Volume 25 , ISSUE 1, 13–17

Article | 20-December-2020

Red cell antibody identification by solid phase red cell adherence utilizing dried RBC monolayers

Recent technological advances in the immobilization and drying of red cell monolayers for use in solid phase red cell adherence (SPRCA) assays have resulted in the development of reagent red cells for antibody screening and identification that are stable at room temperature. Panels consisting of twelve different RBC samples dried onto individual microplate wells were evaluated with 176 samples whose antibody specificities had previously been determined by conventional hemagglutination

Darryl L. Stone, Ralph A. Eatz, Susan D. Rolih, Seaborn J. Farlow, Gordon S. Hudson, Lyle T. Sinor

Immunohematology, Volume 6 , ISSUE 1, 12–17

Article | 16-October-2019

Assessment of common red blood cell pretreatments to yield an accurate serologic antigen phenotype compared with genotype-predicted phenotype

Red blood cell (RBC) phenotyping is valuable for transfusion management of multiply transfused patients, including the determination of the risk of forming alloantibodies. Extended phenotype matching is most commonly used in situations where there is a need to avoid sensitization in a nontransfused patient1 or to avoid further alloimmunization in a patient who has already been sensitized.2–5 Phenotyping of patients in these situations is often hindered by the presence of circulating donor cells

T. Horn, J. Hamilton, J. Kosanke, V.W. Hare, W. Kluver, W. Beres, S. Nance, M.A. Keller

Immunohematology, Volume 33 , ISSUE 4, 147–151

Article | 17-February-2021

Identification of rare blood types in southern Brazil: impact on transfusion support

Currently, 343 red blood cell (RBC) antigens are grouped in 43 blood group systems according to the International Society of Blood Transfusion.1 These antigens induce the formation of RBC alloantibodies that are involved in blood incompatibilities, leading to immediate and delayed hemolytic transfusion reactions, and hemolytic disease of the fetus and newborn.2 The definition of rare blood or a rare donor is not yet well established. In most countries, a blood donor or a patient is considered

C.D.S.R. de Araújo, B.A. Machado, C.D. Reche, L. Maroni, L.C. Garlet, M.M.P. dos Santos, M. Beber, A. Pasqualotti, L. Castilho

Immunohematology, Volume 36 , ISSUE 4, 152–156

Report | 01-December-2019

Low risk of hemolysis after transfusion of uncrossmatched red blood cells

on all recipients including the number of uncrossmatched RBCs transfused. For recipients who had either previously identified clinically significant antibodies or those identified on the day of transfusion, clinical and biochemical data were evaluated to determine whether hemolysis had occurred after uncrossmatched RBC transfusion. There were 218 recipients of 1065 units of uncrossmatched RBCs. Most of the RBCs were administered in the emergency room (48%) followed by the operating room (24%) and

Lisa Radkay, Darrell J. Triulzi, Mark H. Yazer

Immunohematology, Volume 28 , ISSUE 2, 39–44

Article | 18-October-2020

Quantitation of red cell-bound immunoglobulins and complement in lymphoma patients

Quantitative ELISA may be useful for determining the amount of red blood cell (RBC)-associated immunoglobulins (Igs) in patients with autoimmune hemolytic anemia (AIHA). In idiopathic AIHA, there is about 20 times more RBC-associated IgG and complement than in normal persons. In patients with low-grade lymphomas (particularly, B-CLL and splenic marginal zone lymphoma) autoimmune hemolysis is a component of their anemia. In highgrade malignant lymphomas (i.e, diffuse large B-cell lymphoma and

M. Podberezin, A. Levina, L. Romanova, O. Margolin, O. Nasibov, A.V. Pivnik

Immunohematology, Volume 16 , ISSUE 4, 147–153

Review | 26-October-2019

Kidd blood group system: a review

The Kidd blood group system has been recognized as clinically important in red blood cell (RBC) serology since its identification in 1951. Forty years later, the JK glycoprotein was determined to be a product of SCL14A1 and was identical to the urea transport protein UT-B produced by HUT11A. The functional role of the protein as a urea transporter in RBCs and kidney has been well documented. The polymorphism responsible for the antithetical antigens Jka and Jkb was identified in 1994 as c.838G

Janis R. Hamilton

Immunohematology, Volume 31 , ISSUE 1, 29–35

Article | 01-April-2020

Reduced red blood cell destruction by antibody fragments

Antibodies to blood group antigens can cause immune RBC destruction directly (extravascular destruction) or indirectly through subsequent complement activation (intravascular hemolysis). The Fc portion of the IgG antibody is responsible for the effector functions of immune RBC destruction. We hypothesized that sensitization of RBCs with blood group antigen–specific IgG antibodies lacking their Fc portion would escape from the recipient’s immune system, allowing for a longer survival

Amina Mqadmi, Steven Abramowitz, Xiaoying Zheng, Karina Yazdanbakhsh

Immunohematology, Volume 22 , ISSUE 1, 11–14

Article | 01-April-2020

External quality assessment scheme in red blood cell serology: a 5-year experience in Thailand

results increased from 78.4 to 91.0 percent. In conclusion,an EQAS in RBC serology should be used to compare results from different laboratories and to identify those laboratories that need improvement in testing procedures.

Sasitorn Bejrachandra, Jariya Saipin, Oytip Nathalang, Usanee Siriboonrit, Ekaraj Rungroung, Sudjai Udee

Immunohematology, Volume 22 , ISSUE 1, 1–5

Report | 01-December-2019

Transfusion of D+ red blood cells to D– individuals in trauma situations

To conserve D– red blood cells (RBCs), our facility developed a policy for transfusion of D+ units to D– patients, particularly in trauma situations. To our knowledge, this is the first study looking at D-mismatched RBC transfusion in trauma patients. We developed guidelines for the transfusion of D-mismatched RBCs. Patients were followed by antibody screening and direct antiglobulin testing. Twenty-six patients were identified, and 57.7 percent of the cases were the result of

Amanda Tchakarov, Rhonda Hobbs, Yu Bai

Immunohematology, Volume 30 , ISSUE 4, 149–152

Report | 14-March-2020

The significance of a positive DAT in thalassemia patients

positive DAT than nonalloimmunized patients, but this association was not significant (OR, 2.2; p = 0.11). A positive DAT did not correlate with decreased response to transfusion, RBC survival, hemolysis, or increased transfusion requirements. Only two cases of early alloimmunization were detected by DAT among 288 DATpositive samples studied during 4 years. This study demonstrated that the routine performance of DATs on pretransfusion specimens in thalassemic patients has limited clinical utility, and

Suzanne A. Arinsburg, Donna L. Skerrett, Dorothy Kleinert, Patricia J. Giardina, Melissa M. Cushing

Immunohematology, Volume 26 , ISSUE 3, 87–91

Case report | 01-December-2019

Performance of an automated solid-phase  red cell adherence system compared with  that of a manual gel microcolumn assay for  the identification of antibodies eluted from  red blood cells

from RBCs. Acid eluates from 51 peripheral blood (PB) and 7 cord blood (CB) samples were evaluated by both an automated SPRCA instrument and a manual GMC assay. The concordance rate between the two systems for peripheral RBC samples was 88.2 percent (45 of 51), including cases with alloantibodies (n = 8), warm autoantibodies (n = 12), antibodies with no identifiable specificity (n = 2), and negative results (n = 23). There were six discordant cases, of which four had alloantibodies (including anti

Rachel H. Finck, Rebecca J. Davis, Shih-Mao Teng, Dennis Goldfinger, Alyssa F. Ziman, Qun Lu, Shan Yuan

Immunohematology, Volume 27 , ISSUE 1, 1–5

Case report | 01-December-2019

Red blood cell phenotype matching for various ethnic groups

Patients requiring chronic transfusion support are at risk of alloimmunization after red blood cell (RBC) transfusion because of a disparity between donor and recipient antigen profiles. This research explored the probability of obtaining an exact extended phenotype match between blood donors randomly selected from our institution and patients randomly selected from particular ethnic groups. Blood samples from 1,000 blood donors tested by molecular method were evaluated for the predicted

Karafa S.W. Badjie, Craig D. Tauscher, Camille M. van Buskirk, Clare Wong, Sarah M. Jenkins, Carin Y. Smith, James R. Stubbs

Immunohematology, Volume 27 , ISSUE 1, 12–19

Review | 18-May-2020

Review: the function of blood group-specific RBC membrane components

Jill R. Storry

Immunohematology, Volume 20 , ISSUE 4, 206–216

Case report | 01-April-2020

Red blood cell transfusion in a patient with anti-AnWj: a case report

Robert E. Stowers, Elie M. Richa, James R. Stubbs, S. Breanndan Moore

Immunohematology, Volume 23 , ISSUE 2, 55–58

Article | 15-April-2020

Efficacy of murine monoclonal antibodies in RBC phenotyping of DAT-positive samples

Edmond Lee, Kevin Hart, Gordon Burgess, Gregory R. Halverson, Marion E. Reid

Immunohematology, Volume 22 , ISSUE 4, 161–165

Article | 14-October-2020

Screening for RBC antibodies - what should we expect from antibody detection RBCs

George Garratty

Immunohematology, Volume 18 , ISSUE 3, 71–77

serologic-method-review | 30-November-2020

Freezing and recovering rare red blood cells using liquid nitrogen

.1 When freezing RBCs in LN2, a nonpermeable cryoprotective agent (CPA) is used to protect the RBCs. The CPA works by dehydrating the RBCs, which in turn minimizes intracellular ice formation. This process step is important because the sharp edges of the ice crystals can rupture the RBC membrane and render the sample unusable. In addition, the CPA maintains the structure and form of the macromolecules and stabilizes the RBC membranes.2 There are two main nonpermeable CPAs used for LN2 freezing

B. Eades

Immunohematology, Volume 37 , ISSUE 4, 157–159

Article | 03-November-2020

Comparison of tube and gel red blood cell agglutination techniques in detecting chimeras after major ABO-mismatched allogeneic hematopoietic stem cell transplantation  

We compared the ability of tube and gel red blood cell (RBC) agglutination techniques to follow erythroid engraftment in a patient who received a major ABO-mismatched peripheral blood stem cell transplant and bone marrow transplant. Tube and gel RBC agglutination techniques were used to detect mixed-field reactivity in cell mixtures containing A/O and c+/c– RBCs and the ability of these two technologies to detect RBC chimeras were compared. We detected c+ RBCs in c+/c– RBC

Marni J. Kupferman, Karen M. Cipilone, Jo Lynn Procter, David F. Stroncek

Immunohematology, Volume 14 , ISSUE 2, 63–67

Letter to Editor | 14-October-2020

Letter to the Editors: Irregular RBC antibodies in the sera of Brazilian pregnant women

Marilena Oshiro, Vânia Maria Cação, Corintio Mariani Neto, Orlando C. de O. Barretto

Immunohematology, Volume 19 , ISSUE 3, 95–95

Report | 24-March-2020

Cryopreserving and deglycerolizing sickle cell trait red blood cell components using an automated cell-processing system

RBC components with rare phenotypes are sometimes required for patients with sickle cell disease, and these rare components can often be found among donors with sickle cell trait.  Cryopreserving RBC components from sickle cell trait donors requires a modified deglycerolization method to preserve the integrity of the RBCs.  This study evaluated the feasibility of using an automated cell-processing system to cryopreserve and deglycerolize sickle cell trait donor RBC components. 

Ricci Jo Ackley, A. Hallie Lee-Stroka, Barbara J. Bryant, David F. Stroncek, Karen M. Byrne

Immunohematology, Volume 24 , ISSUE 3, 107–111

original-report | 25-June-2021

Effect of cryopreservation on a rare McLeod donor red blood cell concentrate

Cryopreservation of red blood cell (RBC) concentrates is used for long-term storage of rare phenotyped RBCs to provide life-saving therapies to patients. To produce these components in Canada, blood manufacturers must demonstrate that the production method they use yields RBC units that meet regulatory guidelines for hemolysis, hemoglobin (Hgb) content, and RBC recovery.1 The Canadian Blood Services (CBS) Rare Blood Program maintains a carefully selected inventory of cryopreserved RBCs with

T.R. Turner, G. Clarke, G.A. Denomme, R. Skeate, J.P. Acker

Immunohematology, Volume 37 , ISSUE 2, 78–83

Article | 14-October-2020

Quantitation of red cell–bound IgG, IgA, and IgM in patients with autoimmune hemolytic anemia and blood donors by enzymelinked immunosorbent assay

This paper describes an enzyme immunoassay for the quantitative determination of IgG, IgA, and IgM immunoglobulins on RBCs. Ether eluates made from RBCs were followed by an enzyme-linked immunosorbent assay of immunoglobulin concentration. Calibration curves were derived from immunoglobulin standards and the number of molecules of each isotype per RBC was calculated. The assay was carried out in 200 healthy blood donors and 62 patients with warm autoimmune hemolytic anemia (AIHA), two of them

Antonio A. Bencomo, Martha Díaz, Yalile Alfonso, Odalys Valdés, María E. Alfonso

Immunohematology, Volume 19 , ISSUE 2, 47–53

Article | 15-April-2020

The Charles Drew Program in Missouri:a description of a partnership among a blood center and several hospitals to address the care of patients with sickle cell disease

Sickle cell disease (SCD) is an inherited blood disorder which can be complicated by stroke in infancy and childhood. The primary and secondary prevention of stroke in this patient population is regular RBC transfusion therapy at least every three weeks, but there is no consensus on the ideal RBC transfusion therapy. The Charles Drew Program, a partnership among a blood center and several hospitals affiliated with academic medical centers in Missouri, provides RBCs for the care of patients with

Edahn J. Isaak, Barbara LeChien, Terianne Lindsey, Michael R. DeBaun

Immunohematology, Volume 22 , ISSUE 3, 112–116

Article | 14-October-2020

Murine monoclonal antibodies can be used to type RBCs with a positive DAT

RBCs with a positive DAT due to IgG coating require the use of directly agglutinating reagents or treatment with chemicals to remove sufficient IgG to permit typing of the RBCs with antisera that require use of the IAT. In this study we demonstrate that murine IgG MoAbs to human RBC antigens can be used as an alternative if the anti-mouse IgG is neutralized or affinity purified to prevent cross-reaction with cell-bound IgG. We performed DATs on RBC samples coated with IgG in vivo and in vitro

Gregory R. Halverson, Paula Howard, Harry Malyska, Edith Tossas, Marion E. Reid

Immunohematology, Volume 19 , ISSUE 3, 83–85

Review | 09-October-2019

How to recognize and resolve reagentdependent reactivity: a review

Reagent-dependent reactivity can be described as agglutination of red blood cells (RBCs) in serologic testing that is not related to the interaction of RBC antigens and antibodies that the test system is intended to detect. In other words, reagent-dependent reactivity results in false-positive agglutination reactions in serologic testing. These false-positive reactions can cause confusion in antigen typing and RBC antibody detection and identification procedures, and may result in delays in

Gavin C. Patch, Charles F. Hutchinson, Nancy A. Lang, Ghada Khalife

Immunohematology, Volume 32 , ISSUE 3, 96–99

Case report | 14-October-2020

Red blood cell antigen changes in malignancy: case report and review

Red blood cell (RBC) antigens represent inherited traits and as such, their expression should be constant throughout the life of an individual. We describe a patient in whom the expression of the Rh D and C antigens was lost due to the development of chronic myelogenous leukemia (CML). For this patient, this represented more than a blood bank curiosity but was of critical importance in determining further treatment of the leukemia. The mechanisms behind changes in RBC antigens due to malignancy

Jeffrey L. Winters, Dianna S. Howard

Immunohematology, Volume 17 , ISSUE 1, 1–9

Article | 31-March-2021

Transfusion support during childbirth for a woman with anti-U and the RHD*weak D type 4.0 allele

Hemolytic disease of the fetus and newborn is reliably prevented by proper management, based on antenatal D typing and screening for red blood cell (RBC) antibodies. Many hospital laboratories do not determine the RHD genotype of pregnant women with a serologic weak D phenotype, because these women are often managed as D–.1 However, Rh immune globulin (RhIG) and provision of D– RBC units are unnecessary if D+ RBCs can safely be transfused. An Interorganizational Work Group on RHD Genotyping

Q. Yin, K. Srivastava, D.G. Brust, W.A. Flegel

Immunohematology, Volume 37 , ISSUE 1, 1–4

Report | 01-December-2019

Seroprevalence of unexpected red blood cell antibodies among pregnant women in Uganda

We conducted a population-based, cross-sectional study among pregnant women in Kampala, Uganda, to determine ABO and D blood types and to determine the percentage who have unexpected red blood cell (RBC) antibodies and their specificities. Deidentified blood samples from routine testing of 1001 pregnant women at the Mulago Hospital antenatal clinics in Kampala were typed for ABO and D and screened for the presence of unexpected RBC antibodies with confirmation and subsequent antibody

Kristina Eipl, Clemensia Nakabiito, Kabali Bwogi, Mahnaz Motevalli, Angela Roots, Lorraine Blagg, J. Brooks Jackson

Immunohematology, Volume 28 , ISSUE 4, 115–117

Report | 17-March-2020

Southeast Asian ovalocytosis is associated with increased expression of Duffy antigen receptor for chemokines (DARC)

The Duffy antigen receptor for chemokines (DARC or Fy glycoprotein) carries antigens that are important in blood transfusion and is the main receptor used by Plasmodium vivax to invade reticulocytes. Southeast Asian ovalocytosis (SAO) results from an alteration in RBC membrane protein band 3 and is thought to mitigate susceptibility to falciparum malaria. Expression of some RBC antigens is suppressed by SAO, and we hypothesized that SAO may also reduce Fy expression, potentially leading to

Ian J. Woolley, Paul Hutchinson, John C. Reeder, James W. Kazura, Alfred Cortés

Immunohematology, Volume 25 , ISSUE 2, 63–66

Article | 10-April-2021

A fatal case of acute hemolytic transfusion reaction caused by anti-Wra: case report and review of the literature

~1 in 150,000 RBC transfusions.12 Wra is fully developed at birth, but anti-Wra is otherwise rarely involved in HDFN. This finding may be because the majority of cases of anti-Wra are naturally occurring and, when found, are sometimes automatically assumed to be low titer, cold reacting, and IgM in class and, therefore, are dismissed as being unable to cross the placenta and cause fetal RBC destruction. However, studies have shown that anti-Wra often includes both IgG and IgM.1 Wra is resistant

A. Espinosa, L.J. Garvik, N. Trung Nguyen, B. Jacobsen

Immunohematology, Volume 37 , ISSUE 1, 20–24

Case report | 28-April-2020

Case report: immune anti-D stimulated by transfusion of fresh frozen plasma

FFP has occasionally been reported to generate an immune response to RBC antigens (e.g.,anti-D and anti-Fya). The Council of Europe requires that each unit of FFP have less than 6 ×109/L RBCs. However, there is considerable variation internationally in the method of production and the level and assessment of RBC contamination of FFP . This study reports the case of a 63-year-old group B, D– man who received multiple transfusions of D– blood products over a 4-month period

Marian Connolly, Wendy N. Erber, Dianne E. Grey

Immunohematology, Volume 21 , ISSUE 4, 149–151

Article | 26-October-2019

HEA BeadChipTM technology in immunohematology

Classic methods to determine human red blood cell (RBC) antigens are based on serologic testing. Thanks to increased knowledge of the molecular basis associated with many blood group antigens, it is currently possible to predict their presence or absence on the red cell membrane. Several molecular techniques have been developed to detect the most important allelic variations attributable to single nucleotide polymorphisms. The human erythrocyte antigen (HEA) BeadChip™ system manufactured

Cinzia Paccapelo, Francesca Truglio, Maria Antonietta Villa, Nicoletta Revelli, Maurizio Marconi

Immunohematology, Volume 31 , ISSUE 2, 81–90

Report | 01-December-2019

Cryopreservation of red blood cell units with a modified method of glycerolization and deglycerolization with the ACP 215 device complies with American and European requirements

Current red blood cell (RBC) glycerolization with the ACP 215 device is followed by volume reduction of the glycerolized RBCs before freezing. We investigated a modified method of glycerolization and deglycerolization which eliminates the final centrifugation step that reduces glycerolized RBC supernatant. A total of 37 RBC units collected from healthy volunteers were analyzed. After removal of the supernatant, RBCs were glycerolized using the high glycerol method and stored at –80°C

Jana List, Michaela Horvath, Gerda C. Leitner, Günter Weigel

Immunohematology, Volume 28 , ISSUE 2, 67–73

Article | 18-October-2020

Large-scale use of red blood cell units containing alloantibodies

Many transfusion services are reluctant to accept red blood cell (RBC) units containing antibodies. We evaluated the impact of accepting routine shipments of our region’s inventory of alloantibody-positive RBC units over a 4-month period. All patients’ samples received up to 30 days after transfusion of such units were evaluated for the presence of passively acquired antibody, and labor and reagent costs were determined. During the study period, we received 259 alloantibody

Martha R. Combs, Donald H. Bennett, Marilyn J. Telen

Immunohematology, Volume 16 , ISSUE 3, 120–123

Article | 06-December-2020

Clinical correlation of positive direct antiglobulin tests in patients with sickle cell disease

Serologic findings of immune-mediated hemolytic anemia (autoimmune hemolytic anemia and cold agglutinin disease) are not infrequent in patients with sickle cell disease and can be clinically significant. Features of sickle cell disease that may affect the emergence and intensity of immune-mediated hemolysis include the antigenic stimulation of chronic red blood cell (RBC) transfusions, increased autoantibody production, RBC membrane defects, and functional asplenism. We describe two patients

Raymond L. Comenzo, Marie E. Malachowski, Eugene M. Berkman

Immunohematology, Volume 8 , ISSUE 1, 13–16

Case report | 20-March-2020

New serologic findings in a patient with ulcerative colitis and a warm autoantibody

IgG-RBC sensitization associated with serine proteases is the current prevailing hypothesis used to explain an uncommon phenomenon in which a positive DAT is obtained using the RBCs from a patient’s clotted blood sample but a negative DAT is obtained when testing RBCs from the patient’s unclotted sample. Similarly, the patient’s serum but not plasma will also be reactive by IAT against all RBCs tested. The majority of patients demonstrating this phenomenon have had a history

Thomas G. Lightfoot, Laurie Delia VanThof

Immunohematology, Volume 25 , ISSUE 4, 160–164

Case report | 09-October-2019

Hematologic complications in a patient with Glycine soja polyagglutination following fresh frozen plasma transfusion

whose cryptantigens are exposed. We report a case of Glycine soja polyagglutination occurring in a 60-year-old African-American man with disseminated methicillin-resistant Staphylococcus aureus (MRSA) infection. Prior to transfusion, the patient developed severe anemia of unknown etiology. Following transfusion of 3 units of fresh frozen plasma (FFP), his RBC count could not be determined for 24 days because of RBC agglutination in his blood sample. In addition, the FFP transfusion correlated with

Ryan P. Jajosky, Lloyd O. Cook, Elizabeth Manaloor, James F. Shikle, Roni J. Bollag

Immunohematology, Volume 33 , ISSUE 2, 51–55

Report | 01-December-2019

Prevalence of clinically significant red blood cell alloantibodies in pregnant women at a large tertiary-care facility

More than 50 red blood cell (RBC) alloantibodies are known to cause hemolytic disease of the fetus and newborn (HDFN). Although Rh immune globulin (RhIG) prophylaxis has significantly reduced the incidence of pregnancies complicated by anti-D, the need to detect and monitor maternal alloantibodies capable of causing HDFN is still a concern. The prevalence and specificity of these alloantibodies were determined. In this retrospective study, the prevalence and specificities of unexpected RBC

Heather M. Smith, Rosetta S. Shirey, Sandra K. Thoman, Jay B. Jackson

Immunohematology, Volume 29 , ISSUE 4, 127–130

Case report | 09-October-2019

Development of red blood cell autoantibodies following treatment with checkpoint inhibitors: a new class of anti-neoplastic, immunotherapeutic agents associated with immune dysregulation

chart review, including serologic, hematology, and chemistry laboratory results, of two patients who developed red blood cell (RBC) autoantibodies during treatment with a checkpoint inhibitor. Serologic testing of blood samples from these patients during induction therapy with ipilimumab and nivolumab, respectively, showed their RBCs to be positive by the direct antiglobulin test (IgG+, C3+) and their plasma to contain panreactive RBC autoantibodies. Neither patient had evidence of hemolysis. Both

Laura L.W. Cooling, John Sherbeck, Jonathon C. Mowers, Sheri L. Hugan

Immunohematology, Volume 33 , ISSUE 1, 15–21

Case report | 17-March-2020

Anti-Kpa–induced severe delayed hemolytic transfusion reaction

Kpa is a low-frequency antigen occurring in less than 2 percent of the Caucasian population. Mild to moderate delayed hemolytic transfusion reactions (DHTR) and hemolytic disease of the fetus and newborn attributable to anti-Kpa have been reported. Severe overt DHTR has not been reported with anti-Kpa. A case of a severe DHTR attributed to anti-Kpa after multiple RBC transfusions is being reported. A 52-year-old Caucasian woman received multiple units of RBCs for a lower gastrointestinal bleed

Ranie Koshy, Bhishma Patel, Jonathan S. Harrison

Immunohematology, Volume 25 , ISSUE 2, 44–47

Review | 09-October-2019

A Caucasian JK*A/JK*B woman with Jk(a+b–) red blood cells, anti-Jkb, and a novel JK*B allele c.1038delG

The Kidd blood group on the red blood cell (RBC) glycoprotein urea transporter-B has a growing number of weak and null alleles in its gene SLC14A1 that are emerging from more widespread genotyping of blood donors and patients. We investigated a 64-year-old Caucasian woman of Polish-Czech descent who developed anti-Jkb detected in solid-phase RBC adherence testing within 12 days after 7 units of RBCs were transfused. Her RBCs subsequently typed Jk(a+b–) by licensed reagents and human

Glenn Ramsey, Ricardo D. Sumugod, Paul F. Lindholm, Jules G. Zinni, Jessica A. Keller, Trina Horn, Margaret A. Keller

Immunohematology, Volume 32 , ISSUE 3, 91–95

Article | 16-October-2019

Rouleaux and saline replacement

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

Kayla L. Waider

Immunohematology, Volume 34 , ISSUE 3, 91–92

Review | 16-October-2019

A review of in vitro methods to predict the clinical significance of red blood cell alloantibodies

Sandra J. Nance

Immunohematology, Volume 34 , ISSUE 1, 11–15

Report | 01-December-2019

Blood group antigen distribution in Lao blood donors

Chirapha Keokhamphoui, Yupa Urwijitaroon, Douangchanh Kongphaly, Te Thammavong

Immunohematology, Volume 28 , ISSUE 4, 132–136

Review | 14-December-2020

A review: controversies in blood component use in newborns

Advances in the care of the critically ill neonate have necessitated dramatic changes in the blood bank's response, especially to the needs of the low-weight premature infant. The neonate is now considered a major consumer of blood products, and the packaging and administration of these products must he altered to suit its specialized needs. The indications and preparations for small-volume red blood cell (RBC) transfusions are of particular concern. Small volume RBC transfusions are both

Naomi L.C. Luban

Immunohematology, Volume 7 , ISSUE 1, 1–7

Article | 15-February-2021

Albumin-indirect antiglobulin test

replacement methods.3 These methods were very sensitive when supporting hemagglutination but were not adopted widely in the United States. The albumin method used for routine tube testing in the 1970s and still in use today involves the simple addition of albumin to a RBC suspension/plasma mixture. Two theories as to the mechanism of albumin’s effect exist; one being that the albumin raises the dielectric constant of the test environment. The RBCs’ negative charge (zeta potential) is dispersed, causing

J.R. Hamilton

Immunohematology, Volume 35 , ISSUE 2, 63–64

Article | 17-February-2021

Elimination of HLA antibodies by platelet adsorption

blood cell (RBC) antibodies and make finding serologically compatible blood more difficult. Confirming the presence of HLA antibodies is complicated because HLA typing of reagent RBCs is often not reliable, HLA expression on RBCs is variable, and HLA antigens are not stable during storage.2 Having a method to rid a patient’s serum of these antibodies is beneficial for resolving suspected HLA antibody reactivity. Using platelets for the adsorption of HLA antibodies allows for the detection of

J. Jung, C. Barron

Immunohematology, Volume 36 , ISSUE 1, 1–3

Article | 03-November-2020

K phenotyping using a PK-7200 automated analyzer

K (Kell) is one of the most immunogenic of the red blood cell (RBC) antigens. In order to select K− RBC units, we developed K phenotyping on the Olympus PK-7200 equipment to save labor, time, and costs. The Olympus PK-7200 is fully automated equipment used primarily for blood typing and syphilis screening. We tested 3,587 blood donor samples in EDTA using a commercial anti-K serum diluted in HP Hemagen Power SolutionR(1:40). The equipment was set to prepare a 1.7% RBC suspension in

Marcia C. Zago-Novaretti, Silvana P. Navarro, Pedro E. Dorlhiac-Llacer, Dalton A.F. Chamone

Immunohematology, Volume 14 , ISSUE 1, 22–25

Article | 09-November-2020

Measurement of red blood cell-bound C3b and C3d using an enzyme-linked direct antiglobulin test

Complement has a complex role in immune mediated red blood cell (RBC) destruction and usually induces extravascular hemolysis of C3bcoated RBCs by erythrophagocytosis and by acting synergistically with cell-bound immunoglobulins. A sensitive two-stage enzyme-linked direct antiglobulin test (ELDAT) was developed and used to measure RBC-bound C3b and C3d in 120 healthy adult individuals and in 60 patients suffering from a variety of conditions, including warm- and cold-type autoimmune hemolytic

J.D. Bellamy, D.J. Booker, N.T. James, R. Stamps, R.J. Sokol

Immunohematology, Volume 13 , ISSUE 4, 123–131

Article | 14-December-2020

Indicators of clinically significant red cell antibodies produced by sensitized lymphocytes in liver transplant patients

It has been documented that transplanted livers can carry sensitized lymphocytes that subsequently produce red cell antibodies. We evaluated immunohematological variables in liver donors and recipients for indicators that might be predictive of serological red blood cell (RBC) destruction mediated by the passenger lymphocytes. Organ donor sera with antibody scores greater than ( > ) 60 correlated with a positive direct antiglobulin test (DAT) and need for increased RBC transfusion in liver

BeverIy E.W. Calhoun, M. Pothiawala, G. Musa, B. Baron

Immunohematology, Volume 7 , ISSUE 2, 37–39

Review | 21-March-2020

Neonatal red cell transfusions

This review discusses RBC transfusion in the neonatal age group and explores how one institution arrived at current common practice. Special considerations such as CMV infectious risk and GVHD are discussed.

Cathy A. Litty

Immunohematology, Volume 24 , ISSUE 1, 10–14

Original Paper | 09-October-2019

A field analysis trial comparing the turnaround times of routine and STAT red blood cell immunohematology testing

Katie Sackett, Andrea Kjell, Abigail M. Schneider Schneider, Claudia S. Cohn Cohn

Immunohematology, Volume 33 , ISSUE 1, 1–5

Article | 03-November-2020

Comparison of affinity column technology and LISS tube tests

, the antibodies become attached to the RBC surface. When the microcolumns are centrifuged, the RBCs pass through a viscous barrier into an active matrix containing proteins G and A. Positive tests adhere at the top of the gel and negative tests pass through, settling to the bottom. This study was undertaken to compare affinity column technology with low-ionic saline solution (LISS) tube tests in a reference laboratory setting. Over a 1-year period, 314 samples were tested in parallel by affinity

Kayla D. Champagne, Peggy Spruell, Jane Chen, Leslie Voll, Gloria Schlanser, Marilyn Moulds

Immunohematology, Volume 14 , ISSUE 4, 149–151

Review | 01-April-2020

Transfusion of multiple units of Js(b+) red blood cells in the presence of anti-Jsb in a patient with sickleβ-thalassemia disease and a review of the literature

anti-Jsb. In addition to routine serologic methods to study the patient’s RBCs and plasma,a monocyte monolayer assay (MMA) was performed on the patient’s samples obtained 2 and 9 days after transfusion of the Js(b+) RBCs to determine the potential clinical significance of the anti-Jsb. Various laboratory parameters including quantitative hemoglobin fraction analyses were used to monitor for increased RBC destruction. The MMA reactivity of the patient’s anti-Jsb increased from 2.3

Shan Yuan, Nadia P. Ewing, Debra Bailey, Marissa Salvador, Shirong Wang

Immunohematology, Volume 23 , ISSUE 2, 75–80

Article | 14-October-2020

Drug-dependent antibodies with immune hemolytic anemia in AIDS patients

We studied the presence of drug-dependent antibodies (D-DAbs) in 53 patients with AIDS who developed immune hemolytic anemia (IHA). We examined sera and eluates for the presence of D-DAbs. Drug antibodies were detected in 43.4 percent (23/53) of the patients with IHA. Antibodies to more than one drug were detected in 60.8 percent (14/23) of patients with drug-induced IHA (D-IHA). The DAT was positive by RBC-bound IgG in eight patients, RBCbound IgG/C3d in nine, IgG/IgA in three, IgG/IgA/C3d in

Carlos A. González, Liliana Guzmán, Gabriela Nocetti

Immunohematology, Volume 19 , ISSUE 1, 10–15

Article | 17-November-2020

Detection of Lewis, P1, and some MNS blood group system antibodies by a solid phase assay

Some solid phase red cell adherence (SPRCA) assays are designed to detect IgG antibodies to red blood cell (RBC) antigens. These assays use anti-IgG-coated red cells as the indicator. It is reported that most antibodies to Lea, Leb, P1, M, and N fail to react by solid phase (SP), presumably because they are IgM antibodies. Those detected are assumed to be IgG. In one year, during routine testing using SPRCA to screen patients for intended RBC transfusion, 28 of 59 such examples were found

Susan Rolih, Ronald Thomas, Lyle Sinor

Immunohematology, Volume 11 , ISSUE 3, 78–80

Article | 16-October-2019

Detecting polyagglutinable red blood cells

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

Cami Melland, Connie Hintz

Immunohematology, Volume 34 , ISSUE 3, 113–117

Review | 16-October-2019

A brief overview of clinical significance of blood group antibodies

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

Manish J. Gandhi, D. Michael Strong, Barbee I. Whitaker, Evangelia Petrisli

Immunohematology, Volume 34 , ISSUE 1, 4–6

Review | 09-October-2019

Recognizing and resolving ABO discrepancies

Patient samples are routinely typed for ABO prior to transfusion. Determining the ABO group requires both red blood cell (RBC) antigen typing for A and B (forward type) and testing for anti-A and anti-B in the plasma (reverse type). An ABO discrepancy exists when the result of an ABO RBC typing, or forward type, does not agree with the result of the plasma typing, or reverse type. This brief review examines several causes of ABO discrepancies encountered in the clinical transfusion service

Geralyn M. Meny

Immunohematology, Volume 33 , ISSUE 2, 76–81

Review | 14-March-2020

The Cromer blood group system: a review

Jill R. Storry, Marion E. Reid, Mark H. Yazer

Immunohematology, Volume 26 , ISSUE 3, 109–117

Case report | 29-October-2019

Evans syndrome in a pediatric liver transplant recipient with an autoantibody with apparent specificity for the KEL4 (Kpb) antigen  

Although most warm red blood cell (RBC) autoantibodies react broadly with panel cells in addition to the patient’s own RBCs, occasionally an autoantibody with specificity for a specific blood group antigen is encountered. Rare cases of warm autoantibodies with specificity for the Kpb antigen of the Kell blood group system have been described. We report a pediatric transplant recipient with anemia, immune-mediated hemolysis, thrombocytopenia, and a warm autoantibody with apparent anti-Kpb

Scott A. Koepsell, Kerry Burright-Hittner, James D. Landmark

Immunohematology, Volume 30 , ISSUE 1, 14–17

original-report | 30-September-2021

Immune erythrocyte antibodies in adult patients with sickle cell disease and blood donors in Lagos, Nigeria: a comparative study

Erythrocyte antibodies are either naturally occurring or acquired.1,2 The naturally occurring antibodies are produced independent of antigenic exposure and include the ABO, H, Lewis, and P blood group systems.1,3 The acquired antibodies develop after exposure to exogenous antigens through blood transfusion or pregnancy. Acquired antibodies are also termed as immune, unexpected, irregular, or atypical. Red blood cell (RBC) antibodies can also be allogeneic (alloantibodies) or autologous

A.S. Adewoyin, O.A. Daramola, A.A. Ogbenna, T.A. Adeyemo

Immunohematology, Volume 37 , ISSUE 3, 131–137

Article | 17-February-2021

Clinical impacts of DNA-based typing and provision of antigen-matched red blood cell units for chronically transfused patients with thalassemia

Chronic transfusion in patients with thalassemia is often complicated by red blood cell (RBC) alloantibodies to the lacking antigens on the patients’ RBCs. The prevalence of alloantibodies ranges from 4.25 to 37 percent in patients with thalassemia.1–6 Clinically significant alloantibodies can shorten transfused erythrocyte survival due to hemolytic transfusion reactions. To reduce the alloantibody risk, RBC antigen serotyping for Rh (C, c, E, e) and MNS hybrid glycophorins, especially for MNS7

P. Watanaboonyongcharoen, S. Onspun, P. Rojnuckarin

Immunohematology, Volume 36 , ISSUE 4, 137–145

Report | 16-October-2019

Validity and reliability of serologic immunophenotyping of multiple blood group systems by ORTHO Sera with fully automated procedure

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

Ugo Salvadori, Roberto Melotti, Daniela L'Altrella, Massimo Daves, Ahmad Al-Khaffaf, Laura Milizia, Rossana Putzulu, Renata Filippi, Aurelio Carolo, Giuseppe Lippi, Ivo Gentilini

Immunohematology, Volume 34 , ISSUE 4, 140–147

Report | 16-October-2019

Rh and Kell blood group antigen prevalence in a multi-ethnic cohort in Nigeria: implications for local transfusion service

Kell (K) system antigens in Nigeria with the goal of understanding alloimmunization risk in transfusion recipients and improving transfusion safety through the availability of resources, such as antisera for extended RBC typing and antigen panels for alloantibody detection. A multi-ethnic cohort of 302 healthy Nigerian individuals was created to study RBC antigen prevalence. The antigen status of these individuals for Rh and K antigens was determined using commercially prepared antisera and

Ademola Samson Adewoyin, Grace Ming Lee, Titilope Adenike Adeyemo, Omolade Augustina Awodu

Immunohematology, Volume 34 , ISSUE 2, 61–65

Report | 14-March-2020

Absence of hemolytic disease of fetus and newborn despite maternal high-titer IgG anti-Ku

Anti-Ku seen in K0 (Kell-null) individuals has previously been shown to cause severe hemolytic transfusion reactions. Maternal anti-Ku can cause none or moderate to severe hemolytic disease of the fetus and newborn (HDFN). In two of four previously described HDFN cases, intrauterine transfusions were required because of severe anemia. We report a case in which maternal anti-Ku did not cause HDFN. Standard serologic methods were used for RBC antibody screening and identification, adsorption and

Ram M. Kakaiya, Angelica Whaley, Christine Howard-Menk, Jigna Rami, Mona Papari, Sally Campbell-Lee, Zbigniew Malecki

Immunohematology, Volume 26 , ISSUE 3, 119–122

Article | 14-October-2020

ABO and Rh(D) blood typing on the PK 7200 with ready-to-use kits

The performance of ready-to-use kits was evaluated on the PK 7200 blood grouping system. The Olymp Group (kit 1) and Olymp Group II (kit 2) containing anti-A, -B, -AB, and -D reagents were tested for first and second determinations of A, B, and D antigens. More than 500 RBC samples, including several variant ABO and D phenotypes, were evaluated for specificity, repeatability, reproducibility, and sensitivity. Specificity was tested with wellcharacterized reagent RBCs. Repeatability was

Pierre Moncharmont, Annick Plantier, Véronique Chirat, Dominique Rigal

Immunohematology, Volume 19 , ISSUE 2, 54–56

Article | 10-November-2020

The second example of Lu:-7 phenotype: serology and immunochemical studies

-treated or α-chymotrypsin-treated RBCs of common phenotype. By immunoblotting, eluates containing anti-Lu7 from both Mrs. GA and SA reacted with apparently the same bands in RBC membranes of common phenotype as did human anti-Lub, reacted weakly with Lu(a–b–) RBCs of the dominant type, and were nonreactive with SA’s RBC membranes. These findings raise the Lu7 antigen from its Lutheran-related (para-Lutheran) status to a bona fide member of the Lutheran blood group system.

Marion E. Reid, Jack L. Hoffer, Ragnhild Øyen, Edith Alicea-Tossas, Manijeh Sadjadi, Gladys M. Messina

Immunohematology, Volume 12 , ISSUE 2, 66–68

case-report | 25-June-2021

A case series highlighting a common approach to identifying anti-Jk3

In addition, testing the patient’s RBCs using antisera to high-prevalence antigens and RBC genotyping can aid in confirming the antibody specificity.1 Some antibodies to high-prevalence antigens may be suspected based on the patient’s ethnicity, such as anti-Fy3, anti-U, and anti-Jsb among individuals of African descent; anti-Kpb and anti-k among individuals of European descent; anti-H among individuals from the Indian subcontinent; anti-Dib among those of Asian, South American Indian, and Native

D.J.A.M. Talabong, W.E. Kelley

Immunohematology, Volume 37 , ISSUE 2, 84–88

Report | 29-October-2019

Indirect antiglobulin test-crossmatch using low-ionic-strength saline–albumin enhancement medium and reduced incubation time: effectiveness in the detection of most clinically significant antibodies and impact on blood utilization

Indirect antiglobulin test-crossmatch (IAT-XM) using enhancement media such as low-ionic-strength saline (LISS) and polyethylene glycol (PEG) usually requires 15 minutes of incubation. These methods are necessary when testing samples from blood recipients who have a higher risk of alloimmunization. In emergency situations, IAT-XM can be time-consuming and can influence presurgery routine, resulting in more red blood cell (RBC) units being tested and stored to avoid the transfusion of 

Carla Luana Dinardo, Sílvia Leão Bonifácio, Alfredo Mendrone Júnior

Immunohematology, Volume 30 , ISSUE 1, 1–5

case-report | 30-September-2021

A mild case of hemolytic disease of the fetus and newborn due to anti-Sc2

Hemolytic disease of the fetus and newborn (HDFN) occurs when the pregnant mother is alloimmunized with immunoglobulin (Ig)G-type antibodies specific for antigens present on the red blood cells (RBCs) of the fetus. These antibodies cross the placenta, and hemolysis occurs when the maternal antibody binds to the fetal RBC antigens, generating a binding to the Fc receptor of macrophages in the spleen of the fetus. After delivery, the continuous destruction of RBCs can cause progressive anemia and

M.A. Núñez Ahumada, C.E. Arancibia Aros, C.E. Villalobos Pavez, F.M. Pontigo Gonzalez, V. Abarca Arce, M. Sandoval Medrano, S. Reyes Jorquera

Immunohematology, Volume 37 , ISSUE 3, 122–125

Case report | 24-March-2020

Overt immediate hemolytic transfusion reaction attributable to anti-Wra

Wra is a low-prevalence antigen.  Anti-Wra is a relatively common antibody present in approximately 1 in 100 healthy blood donors.  Anti-Wra is reported to cause different degrees of hemolysis in transfusion and in HDN, ranging from benign to severe.  This report describes an acute overt hemolytic transfusion reaction in a patient whose serum contained anti-Wra and who received a Wr(a+) RBC component.

Fouad N. Boctor

Immunohematology, Volume 24 , ISSUE 3, 113–115

Article | 15-April-2020

In search of red blood cells for alloimmunized patients with sickle cell disease

Patients with sickle cell disease (SCD) typically require transfusions with RBC components,which exposes them to numerous,possibly foreign antigens and potentially causes them to produce an antibody or antibodies to the antigens they lack. As transfusion of these patients increases, the likelihood that they will produce an initial antibody or additional antibodies increases. Once a clinically significant antibody is produced, units of RBCs that lack the associated antigen should be transfused

Cynthia Flickinger

Immunohematology, Volume 22 , ISSUE 3, 136–142

Article | 01-April-2020

H-deficient Bombay and paraBombay red blood cells are most strongly agglutinated by the galactophilic lectins of Aplysia and Pseudomonas aeruginosa that detect I and P1 antigens

The galactophilic lectins Aplysia gonad lectin (AGL) and Pseudomonas aeruginosa lectin (PA-IL),which detect human I and P1 RBC antigens, were examined for hemagglutination of H+ (group O and B) and H-deficient (Bombay and para-Bombay phenotype) RBCs. The results were compared with those obtained using two other galactophilic lectins, Maclura pomifera lectin (MPL) and Arachis hypogaea (peanut) agglutinin (PNA), which share T-antigen affinity, and two fucose-binding H-specific lectins, Ulex

Nechama Gilboa-Garber, Dvora Sudakevitz, Cyril Levene, Naomi Rahimi-Levene, Vered Yahalom

Immunohematology, Volume 22 , ISSUE 1, 15–22

Article | 14-October-2020

Loss of enzyme-sensitive antigens due to the presence of leukocytes, neomycin sulfate, and LISS

Previous studies have shown that RBCs with residual WBCs stored in LISS and neomycin sulfate develop characteristics associated with enzyme-treated RBCs. During a mass screening program to antigen type donor RBCs, we observed that the Fya antigens on a RBC sample from an in-house panel became non-detectable with anti-Fya after incubation overnight in Diluent 2 from Micro Typing Systems, Inc. (MTS, Pompano Beach, FL). In response to this observation, we initiated an investigation to determine

Randall W. Velliquette, Paula Howard, Harry Malyska, Marion E. Reid

Immunohematology, Volume 19 , ISSUE 4, 109–111

Article | 17-November-2020

Loss of the Knops blood group system antigens from stored blood

immunoassay and by flow cytometry measurements. The CR1 expression polymorphism was ascertained by a Hind III restriction fragment length polymorphism analysis. RBC membrane proteins were separated by SDS-PAGE and analyzed for CR1 size by immunoblotting. During the 35-day study interval, no notable decrease was found in RBC-CR1 by flow cytometry. However, CR1 protein was shown to be lost by proteolytic cleavage, as well as by vesiculation. This CR1 protein loss may contribute to the variability of

Joann M. Moulds, L. Lee Brown, Elizabeth Brukheimer

Immunohematology, Volume 11 , ISSUE 2, 46–50

Article | 01-April-2020

ISBT 128 blood labeling: introduction and reference laboratory applications  

ISBT 128 will be implemented in the United States during the next two years. In addition to improving unit traceability and lookback tracking, this information technology standard has the power to detect and prevent errors in data entry by using data identifiers and check characters. Additionally,its ability to encode special testing results such as CMV and RBC phenotype on a label provides laboratories a computerized mechanism to verify the accuracy of such labels.

Suzanne H. Butch, Patricia B. Distler

Immunohematology, Volume 22 , ISSUE 1, 30–36

Article | 16-October-2019

Cold autoadsorption

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

Ernest M. Ekema

Immunohematology, Volume 34 , ISSUE 4, 158–160

Article | 15-April-2020

Update on HDFN: new information on long-standing controversies

Hemolytic disease of the fetus and newborn (HDFN) results from maternal IgG antibodies that cross the placenta to the fetal circulation during gestation and cause RBC destruction and complications before birth (HDF), or anemia and hyperbilirubinemia after birth (HDN), or both. In its most severe form,HDF produces hydrops fetalis,which is characterized by total body edema,hepatosplenomegaly,and heart failure and can lead to intrauterine death. Before discovery of Rh immunoglobulin (RhIG), HDFN

Anne F. Eder

Immunohematology, Volume 22 , ISSUE 4, 188–195

Report | 14-March-2020

Attempts to support an immune etiology in 800 patients with direct antiglobulin test–negative hemolytic anemia

Clinical and hematologic evidence of warm autoimmune hemolytic anemia (AIHA) is present in some patients whose direct antiglobulin test (DAT) is negative. The most common causes for AIHA associated with a negative DAT are RBC-bound IgG below the sensitivity threshold of the DAT, RBC-bound IgA and IgM not detectable by routine reagents, and low-affinity IgG that dissociates during the testing process. Samples submitted from 800 patients with hemolytic anemia and a negative DAT were tested by an

Regina M. Leger, Asuncion Co, Penny Hunt, George Garratty

Immunohematology, Volume 26 , ISSUE 4, 156–160

Article | 31-December-2020

Stimulation of Antibody Following 51Chromium Survival Studies

The survival of red blood cells (RBCs) radiolabeled with 51chromium (51Cr) is a reliable method for predicting transfusion compatibility. Approximately 1.0 ml of 51Cr tagged RBCs is infused into the patient and samples are drawn at predetermined intervals post infusion to determine RBC survival. Red cells used for the study are usually incompatible with the patient's antibody. This antigenic rechallenge may stimulate further antibody production, which could contribute to accelerated

Susan S. Esty, Delores Mallory, Richard J. Davey, Tracy Wahl, Julie Zswisza

Immunohematology, Volume 3 , ISSUE 1, 6–8

Article | 17-February-2021

Blood component administration to multiple myeloma patients treated with daratumumab: suggesting a novel approach with use of 0.1 M dithiothreitol

, and now guidelines have been laid down by AABB and the British Society for Haematology (BSH) for handling pre-transfusion testing on samples from patients on DARA.4 Treating RBCs with dithiothreitol (DTT) eliminates the DARA interference. DTT denatures the cell surface CD38 by disrupting the disulphide bonds, thus preventing interaction of DARA at the RBC surface and allowing for safe transfusion of patients on DARA.5,6 DTT treatment of RBCs also denatures some of the RBC antigens, such as MER2

P. Pandey, D. Setya, E. Kaul, S. Ranjan, M.K. Singh, A. Shankar

Immunohematology, Volume 36 , ISSUE 4, 157–165

Review | 01-December-2019

EDTA glycine acid treatment of red blood cells

IgG dissociation is necessary when a sample is direct antiglobulin test (DAT) positive and antigen testing using blood grouping serum reactive by the antiglobulin test is performed. Exposure of IgG-coated red blood cells (RBCs) to a low pH of 3.0 with EDTA glycine acid successfully dissociates the IgG, rendering the RBCs DAT negative 82 to 85 percent of the time. The procedure takes one minute or less and leaves RBC antigens intact and able to be typed except for those antigens in the Kell

Joanne Kosanke

Immunohematology, Volume 28 , ISSUE 3, 95–96

Report | 25-March-2020

DNA-based assays for patient testing: their application, interpretation, and correlation of results

DNA analysis for the prediction of RBC phenotype has broad implication in transfusion medicine.  Hemagglutination testing, long the gold standard for immunohematology testing, has significant limitations.  DNA analysis affords a useful addition to the arsenal of methods used to resolve complex serologic investigations.  This report discusses the interpretation of results obtained by DNA analyses and their correlation with serologic results.  Some current applications to

Christine Lomas-Francis, Helene DePalma

Immunohematology, Volume 24 , ISSUE 4, 180–190

Report | 01-December-2019

Alloimmunization of patients by blood units harboring distinct DEL variants

eight DEL donors. Coincidentally, Canadian Blood Services (CBS) performed a traceback study by investigating the RHD status of donors after a D– recipient developed anti-D after transfusion of two D– red blood cell (RBC) units. Donor genotyping was done either manually (HQ) or using the Progenika Bloodchip platform (CBS). Donations were traced through computer records. Letters were sent to hospital blood bank physicians to verify the presence of anti-D in recipients and to donors to

Maryse St-Louis, André Lebrun, Mindy Goldman, Marianne Lavoie

Immunohematology, Volume 29 , ISSUE 4, 136–140

Report | 01-December-2019

Directed blood donor program decreases donor exposure for children with sickle cell disease requiring chronic transfusion

of extended red blood cell (RBC) antigen matching for C, E, and K has been well documented in a clinical trial setting but not extensively evaluated in a standard care setting. The goal of this study is to assess the effectiveness in reducing alloimmunization when matching for C, E, and K and the magnitude of the decrease in donor exposure in a directed blood donor program. The rate of alloimmunization and reduction of donor exposure were determined during the course of 1 year in a cohort of

Dionna O. Roberts, Brittany Covert, Terianne Lindsey, Vincent Edwards, Lisa McLaughlin, John Theus, Ricardo J. Wray, Keri Jupka, David Baker, Mary Robbins, Michael R. DeBaun

Immunohematology, Volume 28 , ISSUE 1, 7–12

Article | 16-October-2019

Utility of chloroquine diphosphate in the blood bank laboratory

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

Thandar Aye, Patricia A. Arndt

Immunohematology, Volume 34 , ISSUE 3, 98–102

Article | 17-November-2020

Elimination of a requirement for Vel-negative red blood cells and successful transfusion following chromium-51 survival study

inconclusive anti-Vel serology with an in vivo recovery study simplified the acquisition of blood for this patient and conserved rare RBC units.

Richard J. Davey, Jo Lynn Procter

Immunohematology, Volume 11 , ISSUE 2, 39–42

case-report | 25-June-2021

Anti-A1Leb: a mind boggler

The Lewis blood group system (Le) is unique because it is the only system in which the antigens are not synthesized by red blood cells (RBCs); rather, the antigens are passively adsorbed onto the RBC membrane.1 Le antigens are soluble carbohydrate moieties formed by tissue cells and secreted by body secretions like saliva, where they appear as glycoproteins; in plasma, however, they appear as glycolipids. The Le phenotype depends on ABH secretor status of an individual, although FUT2 and FUT3

A. Gupta, K. Chaudhary, S. Asati, B. Kakkar

Immunohematology, Volume 37 , ISSUE 2, 69–71

Report | 01-December-2019

Should blood donors be routinely screened for irregular antibodies?

components to avoid transfusion-related acute lung syndrome. Total blood donor population between 2007 and 2009 was 60,309 (55.4% male and 44.6% female). Cells I and II were used for alloantibody screening following the Autovue protocol. Positive samples were identified by red blood cell (RBC) panels (Panel A, Panel B, and Panel C, Ortho Clinical Diagnostics, Raritan, NJ). Alloantibody and CSAA frequency were established for both sexes. The database for RBC antigens estimated for the Colombian population

Michel Andrés García, Leonardo Bautista, Fernando Palomino

Immunohematology, Volume 28 , ISSUE 2, 60–66

Report | 25-March-2020

From DNA to blood groups

A blood group antigen is a protein or carbohydrate on the outer surface of a RBC.  Portions of DNA are transcribed and translated into proteins.  A protein-based blood group antigen is the direct product of a gene whereas a carbohydrate-based blood group antigen is an indirect product of a gene; the gene product is a glycosyltransferase that transfers a carbohydrate moiety to a protein, or to another carbohydrate to form a chain of sugars.  This report gives a brief description

Marion E. Reid

Immunohematology, Volume 24 , ISSUE 4, 166–169

Article | 16-November-2020

A method to detect McLeod phenotype red blood cells

flow cytometry (control cells 441). Monoclonal anti-k (F7) and human polyclonal anti-k (C30A-1) gave stronger reactions by hemagglutination with RBCs from McLeod males and were not appropriate to differentiate RBCs with the McLeod phenotype from RBCs with normal Kell antigen expression. Crisp mixed-field agglutination was obtained in tests with monoclonal anti-K14 versus RBCs from the 12 obligate carrier females. Flow cytometry using anti-K14 also clearly identified two RBC populations (median

Ragnhild Øyen, Marion E. Reid, Pablo Rubinstein, Harold Ralph

Immunohematology, Volume 12 , ISSUE 4, 160–163

Article | 22-January-2021

Routine indirect antiglobulin testing of blood donors—a further step toward blood safety: an experience from a tertiary care center in northern India

The primary goal of blood transfusion services is to provide the safest and most effective blood components to patients in need.1,2 This goal pertains to achieving the expected clinical outcomes and safeguarding against transfusion-transmitted infections. In addition, the blood and blood components should be free of alloantibodies directed against the recipient’s red blood cell (RBC) antigens, thereby minimizing the risk of adverse transfusion reactions. This risk is more relevant in plasma

S. Malhotra, G. Negi, D. Kaur, S.K. Meinia, A.K. Tiwari, S. Mitra

Immunohematology, Volume 36 , ISSUE 3, 93–98

Article | 14-October-2020

Antibodies detected in samples from 21,730 pregnant women

Although anti-D is still the main cause of HDN, many other antibodies have been implicated. From September 1995 to April 2000,screening for RBC antibodies was performed on samples from 21,730 pregnant women regardless of RhD type. Standard tube and gel methods were used. Anti-D was identified in 254 samples;other antibody specificities were detected in 376 samples, for a total of 630 antibodies. For this study, 522 antibodies were considered clinically significant. The incidence of potentially

Snezana Jovanovic-Srzentic, Milan Djokic, Nenad Tijanic, Radmila Djordjevic, Nada Rizvan, Darko Plecas, Dejan Filimonovic

Immunohematology, Volume 19 , ISSUE 3, 89–92

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