TRANSFUSION IN THE PRESENCE OF MULTIPLE ALLOANTIBODIES PLUS COLD-REACTIVE AGGLUTININS/DAT+.
(Abstract release date: 05/19/16)
EHA Library. Garcia Fernandez J. 06/09/16; 135129; PB2229
Mr. Jose Ramon Garcia Fernandez
Contributions
Contributions
Abstract
Abstract: PB2229
Type: Publication Only
Background
Transfusion in the presence of allloantibodies is a common procedure in blood-banks. The challenge appears when alloantibodies are multiple and associated with “benign” antibodies or another inespecific laboratory finding that cover up the clinically significant antibodies. The grade of difficulty grow up if the presentation of alloantibodies is detected at the same time rather than in succession.
Aims
We exposed two cases of multiple clinically significant alloantibodies, classified as group I (antibodies that react at 37ºC and that cause a significant majority of transfusion reactions, related to systems: AB0, Rh, Kell, Duffy, Kidd and Ss)
Methods
We describe the last two complex positive inmunohematological studies perfomed in our community hospital
Results
Case1: Pluripathological woman 86 years old, without pregnancies and without previous studies in our hospital. She has received just one transfusion of 2 red cells concentrates, two years before in another hospital. IAT Positive in emergency room with subsequent study in table 1. Probability to find compatible 0 positive blood: 2 %Case 2: Man 68 years old with sever hepatic disease, multiple blood transfusion in the past 7 years due to gastrointestinal bleeding. He needs urgent transfusion for the same reason. Previously he has developed several alloantibodies successively as reported in table 1. Probability to find compatible 0 positive blood: 6 %The challenge of transfusion in these cases are associated with four facts:1.-Number and specificity of alloantibodies2.-Timing of apparition of alloantibodies3.-Absolute necessity of blood transfusion in life-threatening situations4.-Presence of others events that difficult the identification of alloantibodies: cold-reactive antibodies, positive direct antiglobulin test,..TABLE 1: ANTIBODIES DETECTED IN BLOOD TRANSFUSION RECIPIENTS
Conclusion
The presentation of multiple anti-erythrocytes alloantibodies associated with non-specific/bening serological findings in life-threatening situations required and appropriated and immediate evaluation of the patient to decide if transfusion can be delayed or not, simultaneously efforts can be made in order to identify the facts clinically significatives to avoid serological related conditions that mask the real problem focussed in antibodies group I related. We think that transfusion of incompatible blood, in a hemodynamic unstable patient due to others diseases, should be avoided. If anaemia is the exclusively cause of instability we should consider the risk of transfusing incompatible blood.
Session topic: E-poster
Keyword(s): Antibody response, Transfusion
Type: Publication Only
Background
Transfusion in the presence of allloantibodies is a common procedure in blood-banks. The challenge appears when alloantibodies are multiple and associated with “benign” antibodies or another inespecific laboratory finding that cover up the clinically significant antibodies. The grade of difficulty grow up if the presentation of alloantibodies is detected at the same time rather than in succession.
Aims
We exposed two cases of multiple clinically significant alloantibodies, classified as group I (antibodies that react at 37ºC and that cause a significant majority of transfusion reactions, related to systems: AB0, Rh, Kell, Duffy, Kidd and Ss)
Methods
We describe the last two complex positive inmunohematological studies perfomed in our community hospital
Results
Case1: Pluripathological woman 86 years old, without pregnancies and without previous studies in our hospital. She has received just one transfusion of 2 red cells concentrates, two years before in another hospital. IAT Positive in emergency room with subsequent study in table 1. Probability to find compatible 0 positive blood: 2 %Case 2: Man 68 years old with sever hepatic disease, multiple blood transfusion in the past 7 years due to gastrointestinal bleeding. He needs urgent transfusion for the same reason. Previously he has developed several alloantibodies successively as reported in table 1. Probability to find compatible 0 positive blood: 6 %The challenge of transfusion in these cases are associated with four facts:1.-Number and specificity of alloantibodies2.-Timing of apparition of alloantibodies3.-Absolute necessity of blood transfusion in life-threatening situations4.-Presence of others events that difficult the identification of alloantibodies: cold-reactive antibodies, positive direct antiglobulin test,..TABLE 1: ANTIBODIES DETECTED IN BLOOD TRANSFUSION RECIPIENTS
| Blood Group | Fenotyphe | Antibodies | Other facts | |
| Patient1Woman 86 y | O POSDcEe | K(-) k(+)Fya(-)Fyb(+)JKa(-)JKb(+)M(-)N(+)S(-)s(+) | Anti-CAnti-KAnti-FyaAnti-JKa | DAT +Autocontrol + |
| Patient 2Man 68 y | 0 POSDCe | K(-) k(+)Fya(+)Fyb(+)JKa(+)JKb(-)M(+)N(+)S(-)s(+) | Anti-EAnti-cAnti-JKbAnti-S | Cold-reactive antibodies + (Anti-I) |
Conclusion
The presentation of multiple anti-erythrocytes alloantibodies associated with non-specific/bening serological findings in life-threatening situations required and appropriated and immediate evaluation of the patient to decide if transfusion can be delayed or not, simultaneously efforts can be made in order to identify the facts clinically significatives to avoid serological related conditions that mask the real problem focussed in antibodies group I related. We think that transfusion of incompatible blood, in a hemodynamic unstable patient due to others diseases, should be avoided. If anaemia is the exclusively cause of instability we should consider the risk of transfusing incompatible blood.
Session topic: E-poster
Keyword(s): Antibody response, Transfusion
Abstract: PB2229
Type: Publication Only
Background
Transfusion in the presence of allloantibodies is a common procedure in blood-banks. The challenge appears when alloantibodies are multiple and associated with “benign” antibodies or another inespecific laboratory finding that cover up the clinically significant antibodies. The grade of difficulty grow up if the presentation of alloantibodies is detected at the same time rather than in succession.
Aims
We exposed two cases of multiple clinically significant alloantibodies, classified as group I (antibodies that react at 37ºC and that cause a significant majority of transfusion reactions, related to systems: AB0, Rh, Kell, Duffy, Kidd and Ss)
Methods
We describe the last two complex positive inmunohematological studies perfomed in our community hospital
Results
Case1: Pluripathological woman 86 years old, without pregnancies and without previous studies in our hospital. She has received just one transfusion of 2 red cells concentrates, two years before in another hospital. IAT Positive in emergency room with subsequent study in table 1. Probability to find compatible 0 positive blood: 2 %Case 2: Man 68 years old with sever hepatic disease, multiple blood transfusion in the past 7 years due to gastrointestinal bleeding. He needs urgent transfusion for the same reason. Previously he has developed several alloantibodies successively as reported in table 1. Probability to find compatible 0 positive blood: 6 %The challenge of transfusion in these cases are associated with four facts:1.-Number and specificity of alloantibodies2.-Timing of apparition of alloantibodies3.-Absolute necessity of blood transfusion in life-threatening situations4.-Presence of others events that difficult the identification of alloantibodies: cold-reactive antibodies, positive direct antiglobulin test,..TABLE 1: ANTIBODIES DETECTED IN BLOOD TRANSFUSION RECIPIENTS
Conclusion
The presentation of multiple anti-erythrocytes alloantibodies associated with non-specific/bening serological findings in life-threatening situations required and appropriated and immediate evaluation of the patient to decide if transfusion can be delayed or not, simultaneously efforts can be made in order to identify the facts clinically significatives to avoid serological related conditions that mask the real problem focussed in antibodies group I related. We think that transfusion of incompatible blood, in a hemodynamic unstable patient due to others diseases, should be avoided. If anaemia is the exclusively cause of instability we should consider the risk of transfusing incompatible blood.
Session topic: E-poster
Keyword(s): Antibody response, Transfusion
Type: Publication Only
Background
Transfusion in the presence of allloantibodies is a common procedure in blood-banks. The challenge appears when alloantibodies are multiple and associated with “benign” antibodies or another inespecific laboratory finding that cover up the clinically significant antibodies. The grade of difficulty grow up if the presentation of alloantibodies is detected at the same time rather than in succession.
Aims
We exposed two cases of multiple clinically significant alloantibodies, classified as group I (antibodies that react at 37ºC and that cause a significant majority of transfusion reactions, related to systems: AB0, Rh, Kell, Duffy, Kidd and Ss)
Methods
We describe the last two complex positive inmunohematological studies perfomed in our community hospital
Results
Case1: Pluripathological woman 86 years old, without pregnancies and without previous studies in our hospital. She has received just one transfusion of 2 red cells concentrates, two years before in another hospital. IAT Positive in emergency room with subsequent study in table 1. Probability to find compatible 0 positive blood: 2 %Case 2: Man 68 years old with sever hepatic disease, multiple blood transfusion in the past 7 years due to gastrointestinal bleeding. He needs urgent transfusion for the same reason. Previously he has developed several alloantibodies successively as reported in table 1. Probability to find compatible 0 positive blood: 6 %The challenge of transfusion in these cases are associated with four facts:1.-Number and specificity of alloantibodies2.-Timing of apparition of alloantibodies3.-Absolute necessity of blood transfusion in life-threatening situations4.-Presence of others events that difficult the identification of alloantibodies: cold-reactive antibodies, positive direct antiglobulin test,..TABLE 1: ANTIBODIES DETECTED IN BLOOD TRANSFUSION RECIPIENTS
| Blood Group | Fenotyphe | Antibodies | Other facts | |
| Patient1Woman 86 y | O POSDcEe | K(-) k(+)Fya(-)Fyb(+)JKa(-)JKb(+)M(-)N(+)S(-)s(+) | Anti-CAnti-KAnti-FyaAnti-JKa | DAT +Autocontrol + |
| Patient 2Man 68 y | 0 POSDCe | K(-) k(+)Fya(+)Fyb(+)JKa(+)JKb(-)M(+)N(+)S(-)s(+) | Anti-EAnti-cAnti-JKbAnti-S | Cold-reactive antibodies + (Anti-I) |
Conclusion
The presentation of multiple anti-erythrocytes alloantibodies associated with non-specific/bening serological findings in life-threatening situations required and appropriated and immediate evaluation of the patient to decide if transfusion can be delayed or not, simultaneously efforts can be made in order to identify the facts clinically significatives to avoid serological related conditions that mask the real problem focussed in antibodies group I related. We think that transfusion of incompatible blood, in a hemodynamic unstable patient due to others diseases, should be avoided. If anaemia is the exclusively cause of instability we should consider the risk of transfusing incompatible blood.
Session topic: E-poster
Keyword(s): Antibody response, Transfusion
{{ help_message }}
{{filter}}