Delayed Serologic Transfusion Reaction (DSTR), Antibodies to low frequency red cell antigens

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Adverse Occurrence type: 
MPHO Type: 
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.
Demonstration of imputability or root cause: 
By definition, these are antibodies that have been identified by serologic and/or genetic analysis and include: Batty (By), Christiansen (Chr(a)), Biles (Bi), Box (Bx(a)), Torkildsen (To(a)), Peters (Py(a)), Reid (Re (a)), Jensen (Je(a)), Livesay (Li(a)), Milne, Rasmussen (RASM), JFV, Katagiri (Kg), Jones (JONES), H. In routine blood group serology, low frequency antigens (LFA) can be disclosed in one of the following ways: 1) Compatibility tests (LFA on donor's red cells), 2) Antibody screening (previously unsuspected LFA on reagent red cells), 3) typing discrepancy (anti-LFA in reagent), 4) Hemolytic Disease of the Newborn (HDN) (mother has anti-LFA against paternal red cells), 5) Transfusion reactions (anti-LFA missed in compatibility test) and 6) Deliberate screening for LFAs.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest new keywords: 
Batty (By), Christiansen (Chr(a)), Biles (Bi), Box (Bx(a)), Torkildsen (To(a)), Peters (Py(a)), Reid (Re (a)), Jensen (Je(a)), Livesay (Li(a)), Milne, Rasmussen (RASM), JFV, Katagiri Kg), Jones (JONES), H, ISBT, low frequency antigens, LFA,
Reference attachment: 
Suggest references: 
Lubenko, A. and Contreras, M. (1989). A review: low-frequency red cell antigens. Immunohematology 5(1):7-14.
Expert comments for publication: 
Low frequency or low incidence antigens are defined by the Working Party of the International Society for Blood Transfusion (ISBT). Some antibodies to low-frequency antigens are extremely rare and, although there is no evidence that they have caused hemolytic transfusion reactions, they are likely to have the potential should the opportunity arise. Quite often, antigens that have very low frequencies in one population are not that infrequent in another (e.g. , the antigens Mur, Hut, and Hil of the Milli phenotype). In addition, "low-frequency" antigens (LFAs) of one ethnic group (e.g., K, jsa) can have an appreciable incidence in another ethnic group within the same population. Hence, there is no rigid definition as to what constitutes a LFA.