Delayed Hemolytic Transfusion Reaction with Alloimmunization of Rh Phenotype: A Two-Case Study / 대한수혈학회지

Delayed hemolytic transfusion reaction is difficult to prevent using an unexpected antibody test performed prior to transfusion, and unlike acute hemolytic transfusion reaction, it occurs a few days after blood transfusion. Hence, determining the reason for delayed hemolytic transfusion reaction may be a tim-consuming task for clinicians Here, we report our experience of two cases of delayed hemolytic transfusion reaction as a result of the unexpected antibody production to Rh blood group antigens after transfusion. The first patient with a history of transfusion during admission was identified as having anti-E and anti-C antibodies according to the antibody identification test at the time of re-admission. The second patient who had chronic blood transfusion due to cancer treatment was found to have anti-C antibody. Both patients received transfusion of Rh antigen-compatible RBC units only after unexpected antibody development. However, like both cases, patients receiving continuous blood transfusion should be considered for a routine Rh phenotype test.

Discrepant Frequency of Rh Subtype and Kell Blood Group Antigens between Korean Pregnant Women and Their Neonates / 대한수혈학회지

BACKGROUND: The causes of hemolytic disease of the newborn are discrepancies of ABO group, Rh(D) or other RBC antigens. The discrepancies of Rh subgroups except Rh(D) and K typing can be seen rarely. The clinical symptoms of those types are mild and most clinicians have no interest in them. However, there exist some serious cases that need exchange transfusion. For that, we detected Rh subgroup phenotyping and Kell typing in blood obtained from cord and pregnant women and the frequency of discrepancy. METHODS: We examined the cord and mother's blood collected from 317 pregnant women from May to November, 1997. Rh(D) typing was done using slide method with anti-D (Dade, USA), and other Rh subgroup phenotyping using column agglutination test on MicroTyping system with Rh-K gel card (DiaMed, Switzerland). Irregular antibody screening was done in the cases of discrepancy. RESLUTS: The most frequent phenotype of Rh subgroup was CDe (41.3%) and then CcDEe (39.3%), but the K typing showed 0%. 90 cases of 317 pair-samples (28.4%) showed discrepancies between pregnant women and their neonates. The most frequent type of Rh discrepancy was c+E (50%) and then C or E (11.1%). 62 cord samples which obtained from neonates of Kyungpook and Chonnam provinces showed discrepancies, were all negative in the irregular antibody screening test. CONCLUSIONS: Rh subgroup phenotyping and irregular antibody screening in cord blood by column agglutination test is thought to be helpful in early diagnosis and treatment of hemolytic disease of the newborn, as a sufficient amount of cord blood can be collected easily rather than neonatal blood.