A Japanese multi-institutional collaborative study of antigen-positive red blood cell (RBC) transfusions in patients with corresponding RBC antibodies

Chiaki Yamada¹, Akihiro Takeshita¹, Hitoshi Ohto², Ken Ishimaru³, Kinuyo Kawabata², Yuriko Nomaguchi⁴, Yasue Haraguchi⁵, Misao Abe⁶, Koki Sobue⁷, Hiroyuki Takenouchi⁸, Junko Takadate⁹, Masami Kamimura¹⁰, Akiko Katai¹¹, Daisuke Kasai¹², Yumiko Minami¹³, Tatsuya Sugimoto¹⁴, Junko Michino¹⁵, Kazuhiro Nagai¹⁶, Mikako Kumagai¹⁷, Yuichi Hasegawa¹⁸, Keiko Ishizuka¹, Naoki Ohtomo¹⁹, Naotomo Yamada²⁰, Kazuo Muroi²¹, Tadashi Matsushita²², Koki Takahashi³

Affiliations

¹ Transfusion and Cell Therapy, Hamamatsu University School of Medicine, Hamamatsu, Japan.
² Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan.
³ Blood Service Headquarters, Japanese Red Cross Society, Minato-ku, Japan.
⁴ Division of Transfusion Medicine, Fukuoka University, Fukuoka, Japan.
⁵ Department of Blood Transfusion Medicine and Cell Therapy, Kagoshima University, Kagoshima, Japan.
⁶ Blood Transfusion & Cell Therapy, Kansai Medical University, Moriguchi, Japan.
⁷ Division of Blood Transfusion, Toho University, Ota-ku, Japan.
⁸ Department of Transfusion and Cell Therapy, University of Miyazaki, Miyazaki, Japan.
⁹ Division of Central Clinical Laboratory, Iwate Medical University, Morioka, Japan.
¹⁰ Division of Blood Transfusion, Niigata University, Niigata, Japan.
¹¹ Department of Transfusion Medicine, Aichi Medical University, Aichi-gun, Japan.
¹² Department of Clinical Laboratory, Nagano Municipal Hospital, Nagano, Japan.
¹³ Division of Transfusion Medicine, Osaka Medical College, Takatsuki, Japan.
¹⁴ Division of Medical Technology and Department of Blood Transfusion Service, Tokai University, Isehara, Japan.
¹⁵ Division of Clinical Laboratory, Transfusion Medicine and Cell Therapy, University of Toyama, Toyama, Japan.
¹⁶ Transfusion and Cell Therapy Unit, Nagasaki University, Nagasaki, Japan.
¹⁷ Division of Blood Transfusion, Akita University, Akita, Japan.
¹⁸ Department of Transfusion Medicine, University of Tsukuba, Tsukuba, Japan.
¹⁹ Center for Transfusion Medicine and Cell Therapy, Tokyo Medical and Dental University, Bunkyo-ku, Japan.
²⁰ Department of Transfusion Medicine, Saga University, Saga, Japan.
²¹ Division of Cell Transplantation and Transfusion, Jichi Medical University, Shimotsuke, Japan.
²² Department of Transfusion Medicine, Nagoya University, Nagoya, Japan.

PMID: 32124460
DOI: 10.1111/vox.12906

Clinical Trial

A Japanese multi-institutional collaborative study of antigen-positive red blood cell (RBC) transfusions in patients with corresponding RBC antibodies

Chiaki Yamada et al. Vox Sang. 2020 Jul.

. 2020 Jul;115(5):456-465.

doi: 10.1111/vox.12906. Epub 2020 Mar 2.

Authors

Affiliations

¹ Transfusion and Cell Therapy, Hamamatsu University School of Medicine, Hamamatsu, Japan.
² Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan.
³ Blood Service Headquarters, Japanese Red Cross Society, Minato-ku, Japan.
⁴ Division of Transfusion Medicine, Fukuoka University, Fukuoka, Japan.
⁵ Department of Blood Transfusion Medicine and Cell Therapy, Kagoshima University, Kagoshima, Japan.
⁶ Blood Transfusion & Cell Therapy, Kansai Medical University, Moriguchi, Japan.
⁷ Division of Blood Transfusion, Toho University, Ota-ku, Japan.
⁸ Department of Transfusion and Cell Therapy, University of Miyazaki, Miyazaki, Japan.
⁹ Division of Central Clinical Laboratory, Iwate Medical University, Morioka, Japan.
¹⁰ Division of Blood Transfusion, Niigata University, Niigata, Japan.
¹¹ Department of Transfusion Medicine, Aichi Medical University, Aichi-gun, Japan.
¹² Department of Clinical Laboratory, Nagano Municipal Hospital, Nagano, Japan.
¹³ Division of Transfusion Medicine, Osaka Medical College, Takatsuki, Japan.
¹⁴ Division of Medical Technology and Department of Blood Transfusion Service, Tokai University, Isehara, Japan.
¹⁵ Division of Clinical Laboratory, Transfusion Medicine and Cell Therapy, University of Toyama, Toyama, Japan.
¹⁶ Transfusion and Cell Therapy Unit, Nagasaki University, Nagasaki, Japan.
¹⁷ Division of Blood Transfusion, Akita University, Akita, Japan.
¹⁸ Department of Transfusion Medicine, University of Tsukuba, Tsukuba, Japan.
¹⁹ Center for Transfusion Medicine and Cell Therapy, Tokyo Medical and Dental University, Bunkyo-ku, Japan.
²⁰ Department of Transfusion Medicine, Saga University, Saga, Japan.
²¹ Division of Cell Transplantation and Transfusion, Jichi Medical University, Shimotsuke, Japan.
²² Department of Transfusion Medicine, Nagoya University, Nagoya, Japan.

PMID: 32124460
DOI: 10.1111/vox.12906

Abstract

Background and objectives: It is sometimes difficult to obtain antigen-negative red blood cells (RBCs) for patients with antibodies against RBCs. However, the frequency and severity of the adverse reactions have not been well elucidated. Here, we conducted a multi-institutional collaborative study to clarify the background, frequency and clinical significance of antigen-positive RBC transfusions to patients with the respective antibodies.

Materials and methods: The survey included the background of patients, antigens on RBCs transfused, total amount of antigen-positive RBCs transfused, results from antibody screen and direct antiglobulin tests, specificity of antibodies, adverse reactions and efficacies. All antibodies were surveyed regardless of their clinical significance.

Results: In all, 826 cases containing 878 antibodies were registered from 45 institutions. The main reasons for antigen-positive RBC transfusions included 'negative by indirect antiglobulin test' (39%) and 'detection of warm autoantibodies' (25%). In 23 cases (3% of total), some adverse reactions were observed after antigen-positive RBC transfusion, and 25 antibodies (9 of 119 clinically significant and 16 of 646 insignificant antibodies) were detected. Non-specific warm autoantibodies were detected in 9 cases, anti-E in 5 cases, 2 cases each of anti-Le^a , anti-Jr^a or cold alloantibodies, and 1 case each of anti-Di^b , anti-Le^b or anti-P1. Other antibodies were detected in 2 further cases. Five (22%) of these 23 cases, who had anti-E (3 cases) or anti-Jr^a (2 cases), experienced clinically apparent haemolysis.

Conclusions: Adverse reactions, especially haemolysis, were more frequently observed in cases with clinically significant antibodies than those with clinically insignificant antibodies (P < 0·001).

Keywords: RBC antigens and antibodies; haemolytic transfusion reaction; immunohaematology; red cell components.

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References

1. Storry JR, Clausen FB, Chen Q, et al.: International society of blood transfusion working party on red cell immunogenetics and blood group terminology: report of the Dubai, Copenhagen and Toronto meetings. Vox Sang 2019; 114:95-102
1. Hamilton JR, Bailey DJ: Identification of antibodies to red cell antigens; in: Fung MK (ed): Technical Manual. 19th edn. AABB, Maryland, 2017; 349-384:
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1. White J, Qureshi H, Massey E, et al.: Guideline for blood grouping and red cell antibody testing in pregnancy. Transf Med 2016; 26:246-263
1. Li L, Huang L, Luo G, et al.: Prenatal treatment of severe fetal hemolytic disease due to anti-M alloimmunization by serial intrauterine transfusions. Taiwan J Obstet Gynecol 2017; 56:379-381

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16K08933/Grant-in-Aid from Ministry of Education, Culture, Sports, Science and Technology (Japan)

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A Japanese multi-institutional collaborative study of antigen-positive red blood cell (RBC) transfusions in patients with corresponding RBC antibodies

Affiliations

A Japanese multi-institutional collaborative study of antigen-positive red blood cell (RBC) transfusions in patients with corresponding RBC antibodies

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical