Detection of red cell alloantibodies in thalassaemia patients

Background: ?-thalassaemia patients receive regular blood transfusion to thrive. Due to antigen disparity between the blood donors and these patients they develop red cell alloantibodies due to alloimmunization.' The objective of this study is to predict the frequency of red cell alloimmunization amongst ?-thalassaemia major patients receiving regular blood transfusion.Methods: This study including 106 patients with ?-thalassaemia was conducted in the department of Transfusion Medicine, S. C. B. Medical College, Cuttack for a period of 12 months. Alloantibodies to different red cell blood group antigens in multi-transfused thalassaemia patients were detected using the glass bead technology for blood group serology in the present study.Results: Out of 106 ?-thalassaemia major patients included in the study, 7.5% of patients developed alloantibodies, all being clinically significant. The alloantibodies were anti-E, anti c, anti e and anti-D. The rate of incidence of these alloantibodies was 3.8%, 1.9%, 0.9% and 0.9% respectively.' There was a significant association between alloantibody formation with number of transfused packed red cells (Mann-Whitney Test: p value = 0.035) and age at first transfusion (p value = 0.001). The factors having no association with alloimmunization to red cell antigens are age and gender.Conclusions: Alloimmunization to various erythrocyte blood group antigens is a common problem in multi-transfused ?-thalassaemia patients. There is an association between number of transfused packed red cells and age at first transfusion with alloantibody formation in the study.

Bombay Blood Group– Detection And Study Of Prevalence Of This Rare Phenotype Along With The Transfusion Recommendations

Four main blood types routinely identified are A,B,AB and O. Bombay phenotype individuals are typed as group O on forward ABO typing. Their red cells lack A,B,H antigens and their sera contain anti-A, anti-B and anti-H. It is important to correctly type individuals who are Bombay phenotypes because these individuals require autologous blood donation or blood from another Bombay individual. The present prospective study was conducted over two years to study the prevalence of Bombay phenotype with transfusion recommendations to the blood recipients. All the donor and patient’s blood group were confirmed by tube method. All blood samples showing O blood group on froward grouping and agglutination with O cell in reverse grouping, were tested for Bombay blood group using anti-H.Out of 76,204 cases constituting 49,604 donors and 26,600 patients, Bombay phenotype was detected in 12 cases (0.015%) constituting 4 number of donors and 8 number of patients. All cases were further ruled out to be para Bombay phenotypes and were found to be non secretor by agglutination inhibition test. Four cases out of 12 patients requiring blood transfusion 3 could be issued Bombay blood group and but death occurred in one case due to delay in the surgery for the unavailability of this rare phenotype. Thus, it is recommended that all blood group donors and patients should be routinely screened by both forward and reverse grouping for screening of Bombay phenotype to reduce the risk of hemolytic transfusion reaction resulting from issue of O blood group to Bombay blood group recipients

Platelet transfusion in a dengue epidemic as per recent WHO classification.

The objective was to study the role of platelet transfusion in a dengue epidemic as management to the reduced platelet count and associated hemorrhagic manifestations. Methods: The study was conducted for a period of four months over 3115 cases of clinically and serologically positive cases of dengue for non-structural protein antigen (NS 1). Results: The patients diagnosed as dengue fever without warning signs constituted the maximum number of cases 2418 (77.6%) followed by dengue fever with warning signs 667 (21.4%), severe dengue 30 (1.0%). In serologically confirmed cases, only 154 patients had platelet count <10000/cumm. The prevalence of bleeding was reported in 667 cases and platelet was transfused in only 724 cases constituting 508 cases of dengue with warning signs and 30 cases of severe dengue. Conclusion: Prophylactic platelet transfusion can be done in thrombocytopenic patients with platelet count less than 10000/cumm and associated hemorrhagic manifestations with count more the above label.