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Article | 14-October-2020

PEG adsorption of autoantibodies causes loss of concomitant alloantibody

Use of polyethylene glycol (PEG) to promote adsorption of autoantibodies is reported to give good recovery of concomitant alloantibodies. In initial experiments, PEG and ZZAP (Ficin and DTT) adsorption procedures were compared for removal of autoantibody and recovery of alloantibody. Postadsorption studies (n = 11) were performed and hemagglutination scores compared. In subsequent studies, equal volumes of alloantibody containing sera, PEG, and antigen-negative red blood cells (RBCs) were used

W. John Judd, Louann Dake

Immunohematology, Volume 17 , ISSUE 3, 82–85

Article | 01-April-2020

An alloantibody to a highprevalence MNS antigen in a person with a GP.JL/Mk phenotype

The low-prevalence MNS blood group antigenTSEN is located at the junction of glycophorinA (GPA) to glycophorin B (GPB) in several hybrid glycophorin molecules. Extremely rare people have RBCs with a double dose of theTSEN antigen and have made an antibody to a high-prevalence MNS antigen. We report the first patient who is heterozygous for GYP.JL and Mk. During prenatal tests,an alloantibody to a high-prevalence antigen was detected in the serum of a 21-year-old Hispanic woman. The antibody

John Ratliff, Susan Veneman, Joan Ward, Christine Lomas-Francis, Kim Hue-Roye, Randall W. Velliquette, Laima Sausais, Twilla Maldonado, Janet Miyamoto, Yolanda Martin, David Slater, Marion E. Reid

Immunohematology, Volume 23 , ISSUE 4, 146–149

Report | 01-December-2019

Should blood donors be routinely screened for irregular antibodies?

Alloantibody reactivity is approximately 0.3 percent in blood donors worldwide. The present study established total alloantibody and clinically significant alloantibody (CSAA) frequencies in all Colombian Red Cross National Blood Bank donors (almost all donors were Colombian). The probability of these alloantibodies reacting with a specific antigen in the general population was also determined, focusing on male CSAA data because routine practice in this blood bank is to discard female plasma

Michel Andrés García, Leonardo Bautista, Fernando Palomino

Immunohematology, Volume 28 , ISSUE 2, 60–66

Original Paper | 09-October-2019

Modeling alloantibody formation to highincidence red blood cell antigens in immune responders using genotypic data  

HIA (12.5% of all, 13.8% of those with a documented exposure). Two of these four patients (50%) had made an alloantibody to another antigen. The odds of forming an antibody to an HIA were not related to the total number of transfusions (p = 0.47), the total number of alloantibodies (p = 0.61), or diagnosis of sickle cell disease (p = 0.77) in simple logistic regression. Adjustment for the other two variables in a multiple logistic regression was also not significant for each variable (p = 0.6, p

Patricia A.R. Brunker, Keerthana Ravindran, R. Sue Shirey

Immunohematology, Volume 33 , ISSUE 1, 9–14

Report | 26-October-2019

Comparative evaluation of gel column agglutination and erythrocyte magnetized technology for red blood cell alloantibody titration

Anju Dubey, Atul Sonker, Rajendra K. Chaudhary

Immunohematology, Volume 31 , ISSUE 1, 1–6

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

case-report | 25-June-2021

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

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

Immunohematology, Volume 37 , ISSUE 2, 84–88

Letter to Editor | 14-December-2020

Letter to the Editor: Is It Alloantibody or Autoantibody?

Susan Rolih, Peter D. Issitt

Immunohematology, Volume 7 , ISSUE 3, 83–84

Case report | 09-October-2019

Acute hemolytic transfusion reaction attributed to anti-Ata

Anti-Ata is a rare alloantibody that can be clinically significant. We report a case of a woman who, after emergency-released uncrossmatched red blood cell transfusion, experienced an acute hemolytic transfusion reaction attributed to anti-Ata. The case presented herein highlights the importance of recognizing that anti-Ata may indeed cause acute hemolytic reactions.

Jay S. Raval, Sarah K. Harm, Bethann Wagner, Darrell J. Triulzi, Mark H. Yazer

Immunohematology, Volume 32 , ISSUE 4, 140–142

Report | 01-December-2019

Warm autoantibodies: time for a change

J. Ryan Nobles, Clare Wong

Immunohematology, Volume 29 , ISSUE 1, 5–10

Article | 28-April-2020

The incidence of red cell alloantibodies underlying panreactive warm autoantibodies

Martin Maley, David G. Bruce, Roderick G. Babb, Angus W. Wells, Mark Williams

Immunohematology, Volume 21 , ISSUE 3, 122–125

Case report | 27-December-2020

A case report: unusual Gerbich antibody in a patient with sickle cell anemia

A patient whose red blood cells (RBCs) typed as Ge:2,3 produced an alloantibody to a high-frequency antigen in the Gerbich system. This antibody was shown to be nonreactive with Ge: -2, -3 RBCs using adsorption-elution studies. A monocyte monolayer assay (MMA) suggested that transfusion of Ge:2,3 RBCs to this patient would have reduced in vivo survival.

Michael I. Gorman, Bobbye Woody

Immunohematology, Volume 5 , ISSUE 2, 55–57

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

Review | 01-December-2019

Allogeneic red blood cell adsorption for removal of warm autoantibody

Christina Barron

Immunohematology, Volume 30 , ISSUE 4, 153–155

Article | 09-November-2020

The use of polyethylene glycol (PEG) to enhance the adsorption of autoantibodies

RBCs, and PEG for 15 minutes at 37°C. The PEG/serum mixture was harvested and used for testing. Six drops of the PEG/serum mixture were tested against reagent RBCs for 15 minutes at 37°C. An antiglobulin test was then performed using anti-IgG. The PEG adsorption technique took a total of 10 hours to completely eliminate autoantibody reactivity in all 19 samples. The reference method required a total of 59.5 hours to adsorb the autoantibodies in all 19 samples. Two weak alloantibody

Christina L. Barron, Mary Beth Brown

Immunohematology, Volume 13 , ISSUE 4, 119–122

Article | 16-October-2019

Adsorption of cold agglutinins with rabbit red blood cells

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

Adam Cobaugh

Immunohematology, Volume 34 , ISSUE 2, 46–48

Review | 06-December-2020

Review: red cell alloantibody formation in the neonate and infant: considerations for current immunohematologic practice

Louis DePalma

Immunohematology, Volume 8 , ISSUE 2, 33–37

Case report | 26-October-2019

Suspected acute hemolytic transfusion reaction mediated by anti-Dia

antibody screening has been unremarkable, particularly when electronic crossmatch is used, because of the potential for an alloantibody against a lowprevalence antigen.

Ashwini Bennett, Ray K. Boyapati, Frank S. Hong

Immunohematology, Volume 31 , ISSUE 4, 163–165

Review | 26-October-2019

CD59: A long-known complement inhibitor has advanced  to a blood group system

alloantibody directed against CD59 was found only recently. So far, the first and sole alloantibody described was detected in a CD59-deficient child. In 2014, CD59 received the status of a blood group system by the International Society for Blood Transfusion Red Cell Immunogenetics and Blood Group Terminology Working Party. Among a variety of almost 20 synonyms, the designation CD59 was chosen for the blood group system and CD59.1 for the wild-type protein. The only three alleles published to date are null

Christof Weinstock, Markus Anliker, Inge von Zabern

Immunohematology, Volume 31 , ISSUE 4, 145–151

Review | 16-October-2019

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

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

Sandra J. Nance

Immunohematology, Volume 34 , ISSUE 1, 11–15

Case report | 01-December-2019

Blood group genotyping in a multitrauma patient: a case report

Currently DNA-based analysis of blood groups is mainly used to improve transfusion safety by reducing alloantibody formation in multiply transfused patients and by monitoring pregnancies at risk for hemolytic disease of the fetus and newborn. We present a case in which genotyping was performed after massive transfusion with unmatched group O, D– blood in a trauma setting. Our patient was genotyped as O1A1 and predicted to be D–, and we therefore transfused group A, D– red

Joyce Curvers, Volkher Scharnhorst, Masja de Haas, Loes Warnier-Wandel, Daan van de Kerkhof

Immunohematology, Volume 28 , ISSUE 3, 85–87

Review | 06-December-2020

Review: the LW blood group system

disease states and in pregnancy, associated with production of apparent alloantibody, remains puzzling, but this phenomenon may eventually help our understanding of the immunology of disease.

Jill Storry

Immunohematology, Volume 8 , ISSUE 4, 87–93

Article | 14-October-2020

Evaluation of a new solid-phase immunoassay for alloantibody detection using bromelin-treated and untreated red blood cells

Toyohiro Tamai, Toshio Mazda

Immunohematology, Volume 17 , ISSUE 1, 17–21

Report | 01-December-2019

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

(3.0%) had one or more unexpected RBC antibodies. Of these 264 women, 107 (40.5%), or 1.2 percent overall, had an alloantibody known to cause HDFN, with a total of 15 different alloantibodies identified. The most common alloantibody found was anti-E (n = 33), followed by anti-M (n = 26) and anti-D (n = 20). In pregnancies of D– women, the most common clinically significant antibodies found were anti-D (n = 20), anti-C (n = 11), and anti-E (n = 2). In pregnancies of D+ women, the most common

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

Immunohematology, Volume 29 , ISSUE 4, 127–130

Article | 01-April-2020

A confusion in antibody identification:anti-D production after anti-hrB

Christine Lomas-Francis, Rosyln Yomtovian, Claire McGrath, Phyllis S. Walker, Marion E. Reid

Immunohematology, Volume 23 , ISSUE 4, 158–160

Article | 30-November-2020

First example of Rh:-32,-46 red cell phenotype

The red cells of a white male blood donor typed as Rh:-1, -2, -3, w4, w5, 6, -17, w19, -31, -32, -34, and -46. Although the donor has no history of transfusion, his serum contains an alloantibody that is weakly reactive with most red blood cells (RBCs) tested. Only Rhnull and D-- RBCs are nonreactive. Reactivity is enhanced with ficin- or papain-treated RBCs and is unaffected by AET or DTT treatment of the RBCs. Previously described Rh:-46 RBCs have been of deletion types D--, D•&bull

Jill Storry, Michael Gorman, Nancy I. Maddox, Ella Toy, Peter D. Issitt, Delores M. Mallory

Immunohematology, Volume 10 , ISSUE 4, 130–133

Review | 20-March-2020

Recognition and management of antibodies to human platelet antigens in platelet transfusion–refractory patients

formation, antibodies to human platelet antigens (HPAs), an even less common immune factor, may rise proportionately. Carefully matched apheresis platelets can substantially improve platelet count increments in the setting of HLA and HPA alloantibody-mediated transfusion refractoriness. An evidence-based HPA testing strategy is described along with the incidence and specificity of HPA antibodies in platelet transfusion refractoriness. Optimal strategies to manage patients with HPA or combined HPA and

Ralph R. Vassallo

Immunohematology, Volume 25 , ISSUE 3, 119–124

Article | 14-December-2020

Procedural errors in antibody identification

were reviewed. There were 41 (3.88%) procedural errors and no misidentification errors. In 25 workups (61% of errors), the selection of cells to rule out underlying alloantibody(ies) was in error. The remaining 16 involved various “slips” (minor mistakes or memory lapses) and clerical errors. Based on an analysis of the probable causes of these errors, potential solutions include 1) developing computer aids to detect “rule-out” errors or missing tests results; 2) providing

Patricia L. Strohm, Philip J. Smith, Jane M. Fraser, Thomas E. Miller, Sally V. Rudmann, Jack W. Smith, Jr., John R. Svirbely, Janice F. Blazina, Melanie S. Kennedy

Immunohematology, Volume 7 , ISSUE 1, 20–22

Article | 21-April-2020

Novel molecular basis of an Inab phenotype  

The Cromer blood group system consists of ten high-prevalence and three low-prevalence antigens carried on decay-accelerating factor (DAF). DAF is found in the cell membranes of RBCs, granulocytes,platelets,and lymphocytes and is widely represented in other body tissues. Sequence analyses of DNA were performed on a blood sample from a 91-year-old Japanese woman whose serum contained an alloantibody to a high-prevalence antigen in the Cromer blood group system (anti-IFC). A blood sample from her

Kim Hue-Roye, Vivien E. Powell, Gita Patel, Debra Lane, Mariska Maguire, Amy Chung, Marion E. Reid

Immunohematology, Volume 21 , ISSUE 2, 53–55

Review | 26-October-2019

Kell and Kx blood group systems

, and alloantibodies to Kell antigens can cause transfusion reactions and hemolytic disease of the fetus and newborn. Kell alloantibodies in pregnancy are known to suppress erythropoiesis, which can result in serious disease despite low amniotic bilirubin levels and low antibody titers. Late-onset anemia with reticulocytopenia is thought to be attributable to the continual suppression of erythropoiesis from residual alloantibody in the infant. Alloimmunization to XK protein is rare, and expressed

Gregory A. Denomme

Immunohematology, Volume 31 , ISSUE 1, 14–19

Article | 20-April-2020

Gene frequencies of the HPA-1 to 6 and Gov human platelet antigens in Thai blood donors

could establish a useful HPA- and HLA-matched plateletpheresis donor file and provide an improvement of platelet alloantibody detection in alloimmune thrombocytopenic patients,and,therefore,a more effective platelet transfusion program.

Pawinee Kupatawintu, Oytip Nathalang, Rachanee O-Charoen, Pimpicha Patmasiriwat

Immunohematology, Volume 21 , ISSUE 1, 5–9

Case report | 09-November-2020

Case report: reporting anti-G as anti-C+D may have misleading clinical implications

Four months after a D– male was transfused with four units of D– red blood cells (RBCs), the results of a standard pretransfusion antibody screen and alloantibody identification panel detected anti-C+D in his serum. This report was interpreted by his physician to be evidence of alloimmunization to the D antigen, which triggered concern that the patient had been transfused previously with D+ RBCs as the result of an error in blood typing or personal identification. After a review of

Archiaus L. Mosley, Jr., Mary Beth Trich, Nanette C. Thomas, S. Gerald Sandler

Immunohematology, Volume 13 , ISSUE 2, 58–60

Report | 25-March-2020

The potential of blood group genotyping for transfusion medicine practice

, electronic selection of units antigen-matched at multiple blood group loci is then possible.  This paper discusses the potential of this approach to improve transfusion therapy by reducing or eliminating alloantibody production in specific patient populations.  These include patients facing long-term transfusion therapy and at high risk for sensitization; patients with warm autoantibodies when compatibility cannot be demonstrated by standard methods; and women for whom the production of

Connie M. Westhoff

Immunohematology, Volume 24 , ISSUE 4, 190–195

Article | 31-December-2020

Stimulation of Antibody Following 51Chromium Survival Studies

destruction of RBCs during subsequent incompatible transfusions. To study this question, blood samples were collected from six patients with a single atypical alloantibody, seven to nine months after 51Cr RBC survival studies had been performed in an unrelated protocol. Blood had not been transfused in the interim. The samples were tested in parallel with pre-survival samples for change in antibody titer and score. In addition, RBCs used for the 51Cr survival study, sensitized in vitro with pre- and post

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

Immunohematology, Volume 3 , ISSUE 1, 6–8

Article | 10-April-2021

Group O blood donors in Iran: evaluation of isoagglutinin titers and immunoglobulin G subclasses

also to determine the cutoff titer value that determines a plasma component to be unsafe.8,9 Unexpected alloantibodies are normally produced through immunization by blood transfusion or pregnancy. Alloantibodies such as anti-M, anti-P1, anti-H, and anti-I can occur without previous RBC exposure. It has been shown that microbial elements or environmental factors are also involved in alloantibody production.10 Alloantibodies are important in transfusion medicine and can cause complications

S. Arabi, M. Moghaddam, A.A. Pourfathollah, A. Aghaie, M. Mosaed

Immunohematology, Volume 37 , ISSUE 1, 5–12

Article | 26-October-2020

Naturally-occurring anti-Jka in infant twins

with ficin- or papain-treated RBCs. Monocyte monolayer assays using Jk(a+) RBCs sensitized by either twins' serum were nonreactive (0%). RBCs from both parents typed as Jk(a+b+). Both parents’ antibody detection test results by SPRCA assay were negative. The absence of a history of exposure to allogeneic RBCs or possible passive transfer of maternal or other alloantibody classifies these antibodies as naturally-occurring anti-Jka.

Dawn H. Rumsey, Sandra J. Nance, Mary Rubino, S. Gerald Sandler

Immunohematology, Volume 15 , ISSUE 4, 159–162

Article | 18-October-2020

Moderate hemolytic disease of the newborn due to anti-Hr0 in a mother with the D––/D–– phenotype

of follow up. An exchange transfusion was excluded due to the lack of a compatible donor and the physical condition of the mother precluded blood donation. The maternal RBCs were D+C–c–E–e–; only G and Rh29 of the Rh system were expressed. Thus, her probable phenotype was D––/D––. Her alloantibody was identified as anti-Hr0 (anti-Rh17) as it reacted with all red blood cells (RBCs) but not her own, other D--– RBCs, and Rhnull RBCs. The results

Barbara Żupańska, B. Lenkiewicz

Immunohematology, Volume 16 , ISSUE 3, 109–111

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

Case report | 01-December-2019

Molecular analysis of patients with weak D and serologic analysis of those with anti-D (excluding type 1 and type 2)

type 4.2.2, in 1 of 18 with weak D type 11, in 1 of 17 with weak D type 15, and in 1 weak D type 33 individual. Anti-D was demonstrated to be an alloantibody in weak D type 4.0, type 4.2.2, and type 15 individuals, but an autoantibody in weak D type 11 and type 33 individuals. In conclusion, only a complete serologic investigation of individuals with a given weak D type identified by molecular analysis allows concluding on the nature of the antibody. Transfusing weak D type 4.2.2 and type 15

Bach-Nga Pham, Michèle Roussel, Dominique Gien, Maryline Ripaux, Carine Auxerre, Pierre-Yves Le Pennec, Christine Andre-Botte

Immunohematology, Volume 29 , ISSUE 2, 55–62

Article | 29-December-2020

Assessing the clinical significance of anti-Cra and anti-M in a chronically transfused sickle cell patient

An alloantibody to a high-incidence antigen, asso­ciated with multiple other alloantibodies, made it impossible to supply antigen-negative red blood cells (RBCs) for a chronically transfused sickle cell anemia patient. Anti-Cra, -E, -K, -S, -Fya, -Fyb, as well as anti-M reactive at 37°C and in the antiglobulin phase of testing, were identified in the patient’s serum. An extensive search of rare donor files at the American Red Cross and at the American As­sociation of Blood

Mary B. Leatherbarrow, Sandra S. Ellisor, Patricia A. Collins, Deborah K. Douglas, Robert J. Eckrich, Susan S. Esty, Michael L. Baldwin, Paul M. Ness

Immunohematology, Volume 4 , ISSUE 4, 71–74

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

Jsb is a high-frequency antigen.Anti-Jsb is a rare alloantibody,and its clinical significance is poorly documented. We report a case in which a 12-year-old boy of Nigerian descent with sickle βthalassemia presented with multiple alloantibodies, including a panagglutinin and acute chest syndrome, necessitating the emergent transfusion of five units of phenotype-similar,crossmatchincompatible RBCs,four of which were given during an exchange transfusion. The patient was later found to have

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

Immunohematology, Volume 23 , ISSUE 2, 75–80

case-report | 30-September-2021

Development of anti-Jk3 associated with silenced Kidd antigen expression and a novel single nucleotide variant of the JK gene

) and alignment to reference sequence NM_015865 using Sequencher software, v. 5.4.6 (GeneCodes, Ann Arbor, MI). Results As reflected in Table 1, the patient’s plasma demonstrated panreactivity with antibody screening and identification reagent RBCs, with 2–4+ reactivity seen in all testing with a negative autocontrol and a negative DAT. This workup led to suspicion of an alloantibody to a high-prevalence antigen. All other clinically significant alloantibodies were excluded, and we speculate that

P.A. Manrai, A.J. Siddon, K.M. Hager, J.E. Hendrickson, M.A. Keller, C.A. Tormey

Immunohematology, Volume 37 , ISSUE 3, 109–112

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