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Adverse Occurrence type:
A total of 52 patients with antibodies to high frequency antigens were hospitalized on 56 occasions during the 20-month study period, an incidence of 0.04 cases per 100,000 inhabitants per year. Four antibody specificities, anti-Kp(b), anti-Vel, anti-Lu(b), and anti-Yt(a), were identified in two-thirds of the patients.
Alerting signals, symptoms, evidence of occurrence:
There is a DSTR when, after a transfusion, there is demonstration of clinically significant antibodies against red blood cells which were previously absent (as far as is known) and when there are no clinical or laboratory features of hemolysis. This term is synonymous with alloimmunization. In cooperation with reference laboratories and transfusion services in Austria, Germany, and Switzerland, the transfusion support provided to hospitalized patients identified as having antibodies to high frequency antigens was reviewed during a 20-month period. A total of 52 patients with antibodies to were treated in hospitals. Twenty-two of them received 104 units of antigen-negative RBCs. In 23 cases, a deviation from the standard transfusion policy (e.g., transfusion of antigen-incompatible units) occurred. About 20 percent of all units were supplied internationally. Four antibody specificities, anti-Kp(b), anti-Vel, anti-Lu(b), and anti-Yt(a), were identified in two-thirds of the patients.
Demonstration of imputability or root cause:
All immunohematologic reference laboratories and blood banks in Germany, Switzerland, and Austria to report all patients with clinically significant antibodies to high frequency antigens. An antibody was assumed to be clinically significant if the specificity involved had been implicated in hemolytic transfusion reactions or hemolytic disease of the newborn. High frequency antigens included: anti-Kp(b), anti-Vel, anti-Lu(b), anti-Yt(a), anti-Co(a), anti-H, anti-AnWj, anti-Kx, anti-MAM, anti-Fy(ab), anti-Ku, anti-Lan, anti-Lu8, anti-LW(a), anti-Rh17, anti-Tj(a) (PP1Pk), anti-ABTI.
Suggest new keywords:
anti-Kp(b), anti-Vel, anti-Lu(b), anti-Yt(a), anti-Co(a), anti-H, anti-AnWj, anti-Kx, anti-MAM, anti-Fy(ab), anti-Ku, anti-Lan, anti-Lu8, anti-LW(a), anti-Rh17, anti-Tj(a) (PP1Pk)
Seltsam, A., Wagner, F. F., Salama, A. and Flegel, W. A. (2003). Antibodies to high-frequency antigens may decrease the quality of transfusion support: an observational study. Transfusion 43(11):1563-1566.
Expert comments for publication:
Transfusion hazard analyses may consider adverse events related to an insufficient blood supply because it may pose a serious hazard at least for the small and circumscribed group of patients carrying antibodies to high frequency antigens. Rare antibodies to the high frequency antigens can cause severe intravascular hemolytic transfusion reactions.