A Study on the Improvement of Blood Donor Health Questionnaire / 대한수혈학회지

BACKGROUND: For the safety of blood resources, the Blood Donor Health Questionnaire (DHQ) should be modified and improved allowing donors to answer questions with further accuracy. To accomplish this, it is essential to identify any part of this questionnaire that is donors find inconvenient. METHODS: The problems of the current DHQ were examined through a poll of donors at the Korean Red Cross and other hospital blood service centers from November 2008. We also compared the structure and contents of the Korean DHQ to similar document in eight other countries. RESULTS: Donors thought that the current DHQ was too complicated, took too much time (27.3%) and probed too much into a donors private life (51.2%), making it difficult to answer honestly. The Korean DHQ focuses on a deferral period and uses special medical terminology in order for an interviewer to make easy decisions regarding donor eligibility. In contrast, other questionnaires tend to focus on a donor's recall of memory, use simple vocabulary, and emphasize donor's duties, and therefore, these documents are easy for donors to understand and complete CONCLUSION: Donor-oriented DHQs using simply terminology, help donors with memory recall and emphasize a donor's duty. Also, such a document allows donors to answer frankly. Therefore donor-oriented DHQs provide a great degree of blood resource safety than interviewer-oriented DHQs.

No Hemolytic Transfusion Reactions in a Patient with the Apparent Anti-e Autoantibody Following Transfusion of Packed Red Cells with CcDEe Phenotype / 대한수혈학회지

Patients with alloantibody should be transfused with specific antigen negative blood, and in the case of autoantibody, the least incompatible blood on crossmatching can be transfused. Yet any transfusion cases that possessed autoantibody with the apparent antigen specificity have been rarely reported. A 62 year-old-woman with chronic renal failure underwent tests showing that the direct antiglobulin test was positive (2+) for IgG, the autocontrol test was positive, and the Rh phenotype of her erythrocytes was typed as group CcDEe. One unit of the e-positive packed red cells (PRCs) was transfused before an antibody identification test identified this antibody as autoantibody with an apparent e antigen specificity, but the level of hemoglobin increased from 6.3 g/dL to 7.4 g/dL without a hemolytic reaction or other transfusion side-effects.

A Patient with RhD(el) (1227G>A) Failed to Produce Detectable Anti-D after Transfusion of RhD Positive Red Blood Cells / 대한수혈학회지

Only 0.15% of all donors in Korea are RhD negative, which has led to a chronic shortage of RhD negative blood. Most physicians are aware of the potential for RhD alloimmunization after transfusing RhD+ red blood cells into RhD- patients. Hence, the undertransfusion of RhD- patients might be occurring in Korea. A 66-year-old man without a history of transfusion tested negative for anti-D in his serum. In an emergency situation where RhD- blood was unavailable, the patient received two units of RhD+ RBCs. Anti-D was not detected over three months after the transfusion. The red cells of the patient showed no agglutination with the anti-D reagent and a negative result by the standard weak D test. The polymerase chain reaction-sequence specific primers (PCR-SSP) and sequencing revealed D(el) (1227G>A) in the patient.

Reactivity Patterns of Various Anti-D Reagents in 14 Cases with Partial D / 대한진단검사의학회지

BACKGROUND: A weak D type resulted from a quantitative reduction of the RhD antigen, whereas a partial D type resulted from a qualitatively altered RhD protein. Based on different serological properties from a weak D type, a partial D type was suspected in cases with anti-D in their serum or if nonreactive to some reagents. Most Red Cross Blood Centers pay attention to donors in determining RhD typing with a monoclonal anti-D reagent. This study examined the reactivity patterns of 4 different monoclonal anti-D reagents in RhD typing and a weak D test in 14 cases with partial D. MATERIALS AND METHODS: We collected a total of 201, 847 samples from blood donors and screened out 649 samples as Rh-negative in RhD typing with monoclonal anti-D (Bioscot) and bromelin treatment applied to an automatic analyzer between October 2002 and March 2003. Further, we performed RhD typing and weak D test using the tube method with 4 commercially available monoclonal anti-D reagents. In 14 cases with different reactivity patterns, we performed a confirming test for partial D using a `ID-partial RhD-typing' (Diamed, Switzerland) set consisting of 6 monoclonal antibodies. RESULTS: Partial D(DFR) was observed in 92.9% (13/14) and a partial D(indeterminate) was observed in 7.1% (1/14). The red blood cells from 14 cases with partial D were not agglutinated with 4 various commercially available anti-D reagents. However, in subsequently performed weak-D tests, different reactivity to their anti-D reagents were shown, namely irresponsiveness (Dade Behring, 14/14, 100%), trace-to-1+ responsiveness (Ortho-clinical diagnostics, 13/14, 92.9%), trace-to-3+ responsiveness (Bioscot, 14/14, 100%), and 1+-to-3+ responsiveness (GreenCross, Korea, 14/14, 100%). CONCLUSIONS: Considering that the most partial D discovered in the Southwestern area of Korea was partial D(DFR), it is recommended that RhD typing and/or weak D tests in blood donors should be done using more than two anti-D reagents from different clones.