Red cell alloimmunization in multi-transfused chronic renal failure patients undergoing hemodialysis.

Red blood cell (RBC) transfusions are frequently used in the management of patients with chronic renal failure (CRF) undergoing hemodialysis for dialysis-related anaemia. Consequently, they are subject to all hazards associated with repeated transfusions, such as red cell alloimmunization. A retrospective study was performed to estimate the frequency of alloimmunization against red cell antigens in multitransfused CRF patients. A total of 81 patients (67 males & 14 females) with CRF were studied who received a mean of 8.5 units of RBC matched for ABO & Rh(D) antigens only. Using standard techniques (indirect antiglobulin test, enzyme, polyethylene glycol, and low ionic strength solution), we observed a RBC alloimmunization rate of 9.8% (8/81). Nine alloantibodies were detected in 8 patients, and most (88%) involved antigens in the Rhesus & Kell systems. No correlation was observed with the alloantibody formation & number of units transfused. The calculated risk of 1.3% observed in the present study, suggests that renal failure patients are not at a higher risk of red cell alloimmunization than the general population.

Association of Lewis blood group with ischaemic heart disease.

A total of 96 patients (74 males and 22 females) with ischaemic heart disease (IHD) who presented at a hospital in north India for cardiac bypass surgery, percutaneous coronary angioplasty or unstable angina were investigated for Lewis blood group phenotypes. A hundred and four normal healthy blood donors matched for age and sex served as controls. Lewis blood group typing was carried out on red cells using saline haemagglutination technique in a test tube with monoclonal antisera. 29.1 per cent of IHD patients had Le(a-b-) phenotype compared to 9.6 per cent of controls (P < 0.01). The relative risk of IHD for Le(a-b-) phenotype was found to be highly significant (risk = 3.87). We conclude that there is an increased frequency of Le(a-b-) phenotype among Indian patients with IHD.