ABSTRACT
OBJECTIVE: The aim of this study was to analyze the alloimmunization against red blood cells (RBC) among Kuwaiti population. MATERIALS AND METHODS: Retrospective analysis of RBC alloimmunization among 179,045 Kuwaiti patients, pregnant women, and allogeneic blood donors was conducted for the period of 1992-2001. The frequency of 24 alloantibody specificities from 1,278 alloimmunized Kuwaitis was estimated. RESULTS: The prevalence of positive antibody screen in Kuwait was 0.49%. The five most frequently identified alloantibodies were anti-D (27.3%), anti-E (18.5%), anti-K (15.6%), anti-Le(a) (8.7%), and anti-Le(b) (6.6%). Frequency of alloimmunization was greater among Kuwaiti female than male patients (3.2 F to 1 M). Anti-D (p<0.001), anti-E (p=0.05), anti-K (p=0.04) were also more frequently identified alloantibody among Kuwaiti females. CONCLUSION: The results show higher predominance of RBC alloimmunization in females than males. Anti-D, anti-E, and anti-K were the most common clinically significant alloantibodies identified in the Kuwaiti population and were also more frequent among Kuwaiti females.
Subject(s)
Blood Group Antigens/immunology , Isoantibodies/blood , Blood Donors , Blood Group Antigens/genetics , Consanguinity , Female , Humans , Isoantibodies/genetics , Kuwait/epidemiology , Male , Pregnancy , Prevalence , Retrospective Studies , Rho(D) Immune Globulin , Seroepidemiologic Studies , Serologic Tests , Sex DistributionABSTRACT
BACKGROUND: Thalassemia major is a common hemoglobinopathy in the Arabian Gulf region. However, limited data are available on the frequency of RBC alloimmunization and autoimmunization in transfusion-dependent Arab thalassemia patients. STUDY DESIGN AND METHODS: A total of 190 thalassemia major patients were classified as Kuwaiti Arab and non-Kuwaiti Arab. Pretransfusion investigation records were reviewed for the presence of RBC alloantibody and autoantibody, and the age at which RBC alloantibody was developed. RESULTS: Fifty-seven (30%) patients developed RBC alloantibodies. The most common clinically significant alloantibodies were directed against antigens in the Kell and Rh systems. Anti-K developed in 41 (72%) patients followed by anti-E in 26 (45.6%). RBC autoantibodies developed in 21 (11%) patients with and without underlying RBC alloantibodies. Sixty-six (49.6%) RBC alloantibodies developed between the ages of 2 and 10 years. CONCLUSION: Several factors might have contributed to the high alloimmunization and autoimmunization rate observed in this study, including the heterogeneity of the population living in Kuwait, lack of better-matched donors for those patients, and the use of poststorage leukodepleted blood. It is recommended that thalassemia patients receive blood matched for Rh and Kell antigens and prestorage leukodepleted RBCs.
