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Translational Pediatrics Sep 2022To analyze the effect of different times of pregnancy of type O pregnant women on the occurrence of ABO hemolytic disease of the newborn (ABO-HDN).
BACKGROUND
To analyze the effect of different times of pregnancy of type O pregnant women on the occurrence of ABO hemolytic disease of the newborn (ABO-HDN).
METHODS
From December 2018 to December 2021, 725 pregnant women with O blood group (husbands with non-O blood group) who met the inclusion criteria were collected. There were 116 cases of ABO-HDN, which were summarized and analyzed. The pregnant women were divided into primigravida and non-primigravida groups. The influence of the number of pregnancies on the occurrence of ABO-HDN was compared, and the antibody titer of pregnant women with type O blood was monitored. The relationship between antibody titer and HDN in pregnant women was analyzed by hemolysis test and indirect bilirubin concentration.
RESULTS
In the primigravida group, 0 patients with HDN had a titer ≤1:64, 8 (8/26) had a titer of 1:128, 9 (9/20) had a titer of 1:256, 2 (2/4) had a titer of 1:512, and 2 (2/3) had a titer >1:512. In the non-primigravida group, there were 0 cases with a titer ≤1:64, 32 cases (32/78) with a titer of 1:128, and 26 cases (26/46) with a titer of 1:256. The number of cases of ABO incompatibility in maternal and infant groups with different titers of IgG anti-A (B) antibody were 377 cases in the <1:64 group, 130 cases in the 1:64 group, 104 cases in the 1:128 group, 66 cases in the 1:256 group, 32 cases in the 1:512 group, and 16 cases in the >1:512 group. The positive rates of ABO-HDN were 0.0% (0/0), 0.0% (0/0), 38.5% (40/104), 53.0% (35/66), 81.3% (26/32) and 93.8% (15/16), respectively, and the difference was statistically significant (P<0.05).
CONCLUSIONS
The occurrence of ABO-HDN was not significantly related to the blood type of the pregnant woman's husband. Therefore, in order to reduce the degree of hemolysis and avoid the occurrence of bilirubin encephalopathy or even death, pregnant women with antibody titer >1:64 in second or subsequent pregnancies should be closely monitored.
PubMed: 36247885
DOI: 10.21037/tp-22-385 -
Bone Marrow Transplantation Jan 2021Up to 40% of donor-recipient pairs in SCT have some degree of ABO incompatibility, which may cause severe complications. The aim of this study was to describe available...
Up to 40% of donor-recipient pairs in SCT have some degree of ABO incompatibility, which may cause severe complications. The aim of this study was to describe available options and survey current practices by means of a questionnaire circulated within the EBMT Pediatric Diseases Working Party investigators. Major ABO incompatibility (donor's RBCs have antigens missing on the recipient's cell surface, towards which the recipient has circulating isohemagglutinins) requires most frequently an intervention in case of bone marrow grafts, as immediate or delayed hemolysis, delayed erythropoiesis and pure red cell aplasia may occur. RBC depletion from the graft (82%), recipient plasma-exchange (14%) were the most common practices, according to the survey. Graft manipulation is rarely needed in mobilized peripheral blood grafts. In case of minor incompatible grafts (donor has isohemagglutinins directed against recipient RBC antigens), isohemagglutinin depletion from the graft by plasma reduction/centrifugation may be considered, but acute tolerability of minor incompatible grafts is rarely an issue. According to the survey, minor ABO incompatibility was either managed by means of plasma removal from the graft, especially when isohemagglutinin titer was above a certain threshold, or led to no intervention at all (41%). Advantages and disadvantages of each method are discussed.
Topics: ABO Blood-Group System; Blood Group Incompatibility; Bone Marrow Transplantation; Child; Erythrocytes; Hemolysis; Humans
PubMed: 32594103
DOI: 10.1038/s41409-020-0981-7 -
Frontiers in Immunology 2021ABO blood group antigens within grafts are continuously exposed to anti-A/B antibodies in the serum of recipients after ABO-incompatible (ABOi) kidney transplantation...
INTRODUCTION
ABO blood group antigens within grafts are continuously exposed to anti-A/B antibodies in the serum of recipients after ABO-incompatible (ABOi) kidney transplantation and are instrumental in antibody-mediated rejection. Some individuals secrete soluble blood group antigens into body fluids. In this study, we investigated the effect of donor and recipient secretor status on the outcomes of ABOi kidney transplantation.
METHODS
Data of a total of 32 patients with ABOi living donor kidney transplantation were retrospectively collected between 2014 and 2020 in West China Hospital. The genotype and phenotype of both donors and recipients were examined and evaluated with post-transplantation anti-A/B titer changes, graft function, and rejection.
RESULTS
Of the 32 recipients and 32 donors, 23 (71.9%) recipients and 27 (84.4%) donors had secretor genotypes, whereas 9 (28.1%) recipients and 5 (15.6%) donors did not. Anti-A/B titers after ABOi kidney transplantation were not significantly influenced by the secretor status of either donors or recipients. The post-transplantation serum creatinine (Scr) levels and estimated glomerular filtration rate (eGFR) was better in weak- or non-secretor recipients at day 30 (Scr P = 0.047, eGFR P = 0.008), day 90 (Scr P = 0.010, eGFR P = 0.005), and month 9 (eGFR P = 0.008), and recipients from secretor donors had a lower incidence of graft rejection in the first year after ABOi transplantation (P = 0.004).
CONCLUSIONS
A weak secretor status phenotype was found in both genotypes, i.e., individuals who secreted soluble antigens as well as those who did not. The recipient ABH-secretor status may have an influence on early posttransplant renal function, and the donor ABH-secretor status might affect the incidence of graft rejection.
Topics: ABO Blood-Group System; Antibodies; Blood Grouping and Crossmatching; Creatinine; Genotype; Glomerular Filtration Rate; Graft Rejection; Humans; Kidney; Kidney Transplantation; Living Donors; Phenotype; Retrospective Studies; Survival Analysis
PubMed: 34194432
DOI: 10.3389/fimmu.2021.671185 -
Frontiers in Immunology 2021Blood group and tissue incompatibilities remain significant barriers to achieving transplantation. Although no patient should be labeled "un-transplantable" due to blood... (Review)
Review
Blood group and tissue incompatibilities remain significant barriers to achieving transplantation. Although no patient should be labeled "un-transplantable" due to blood group or tissue incompatibility, all candidates should be provided with individualized and realistic counseling regarding their anticipated wait times for deceased donor or kidney paired donation matching, with early referral to expert centers for desensitization when needed. Vital is the careful selection of patients whose health status is such that desensitizing treatment is less likely to cause serious harm and whose anti-HLA antibody status is such that treatment is likely to accomplish the goal of increasing organ offers with an acceptable final crossmatch. Exciting new developments have re-energized the interest and scope of desensitization in the times ahead.
Topics: ABO Blood-Group System; Animals; Desensitization, Immunologic; Graft Rejection; Graft Survival; HLA Antigens; Histocompatibility; History, 20th Century; History, 21st Century; Humans; Immunosuppressive Agents; Isoantibodies; Kidney Transplantation; Treatment Outcome
PubMed: 34394089
DOI: 10.3389/fimmu.2021.696467 -
Annals of Medicine and Surgery (2012) Apr 2024Fetomaternal Rhesus incompatibility is a medical condition that affects the pregnant woman [of blood group (A, B, AB, O) and a negative Rhesus] and the foetus (of...
BACKGROUND
Fetomaternal Rhesus incompatibility is a medical condition that affects the pregnant woman [of blood group (A, B, AB, O) and a negative Rhesus] and the foetus (of positive Rhesus). The objective of this study is to determine the prevalence and to present the clinical characteristics of fetomaternal Rhesus incompatibility in a tertiary care hospital.
METHODS
The authors conducted a retrospective cross-sectional study and 37 participants were recorded during the study period of 4 years.
RESULTS
A total of 11 898 pregnant women admitted to the maternity and 37 of them (women with blood groups A, B, AB or O and with a negative Rhesus) participated in our study, including a frequency of 0.31%. Thirty cases of fetomaternal Rhesus incompatibility were recorded in new-borns. 27 (73%) of the women are from the urban region and the age group between 21 and 25 is the most affected with 37.8%. Twenty-two (59.5%) of pregnant women have blood group O (and negative Rhesus) and primiparous women are the most affected with 64.9%. For the discovery of allo-immunization, 43.2% of women discovered it during the second pregnancy and 48.7% women received a single infusion of Anti-D serum during the first pregnancy. Twelve (40%) new-borns developed jaundice as a perinatal prognosis.
CONCLUSION
Fetomaternal Rhesus incompatibility remains a major problem of maternal health because it is likely to lead to the formation of antibodies in women, which by crossing the placental barrier, they destroy red blood cells and thus cause serious complications.
PubMed: 38576979
DOI: 10.1097/MS9.0000000000001846 -
American Journal of Primatology Jan 2020Pair housing is one of the most important components of behavioral management for caged macaques; however, it can result in aggression and injury if partners are...
Pair housing is one of the most important components of behavioral management for caged macaques; however, it can result in aggression and injury if partners are incompatible. Knowing when to proceed and when to stop social introductions can be challenging, and can have consequences for the partners. We examined whether behavior early in social introductions predicted success (i.e., partners remained cohoused with full contact for at least 28 days) in 724 female-female and 477 male-male rhesus macaque pairs. We took cage side one-zero focal observations on pairs during the first 2 days of full contact, recording social and aggressive behaviors. The majority of pairs (79.6% of female and 83.0% of male) were successful. The most common behaviors exhibited by pairs during these observations were maintaining proximity, tandem threats, and anxiety. Mounting was also relatively common in male pairs. Grooming and close social contact (e.g., touching) were not common in our study. Several behaviors observed on Day 1 significantly predicted pairing success. For females, these included proximity, tandem threat, rump present, mount, and groom. Day 1 predictors of success for male pairs included proximity, tandem threat, rump present, mount, and social contact. Fewer behaviors predicted success on Day 2. Maintaining proximity on Day 2 predicted success for both sexes, but tandem threat predicted success only for females. Behaviors that predicted incompatibility for females on Day 1 included displace, grimace, threat, bite, and other aggressive contacts. Day 1 predictors of separation for male pairs were displaced, grimace, and abnormal behavior. The only Day 2 behavior that correlated with incompatibility was grimace, which was predictive for males. Interestingly, aggression did not predict incompatibility for male pairs. Identifying behaviors exhibited by monkeys early in the pair introduction that are predictive of long-term compatibility can shape pairing decisions, reducing later stress and potential injury.
Topics: Aggression; Animal Husbandry; Animals; Behavior, Animal; Female; Housing, Animal; Macaca mulatta; Male; Social Behavior
PubMed: 31916274
DOI: 10.1002/ajp.23081 -
Annals of Transplantation Oct 2020BACKGROUND Patients receiving ABO-incompatible (ABOi) or human leukocyte antigen (HLA)-incompatible (HLAi) kidney transplantation (KT) require potent immunosuppression...
BACKGROUND Patients receiving ABO-incompatible (ABOi) or human leukocyte antigen (HLA)-incompatible (HLAi) kidney transplantation (KT) require potent immunosuppression and are thus at a higher risk of infectious complications. We evaluated the clinical outcomes of KT stratified by ABO and HLA incompatibilities and identified the factors associated with the clinical outcomes. MATERIAL AND METHODS Recipients who underwent living-related KT between 2012 and 2017 were included and classified into 4 groups: ABO-compatible and HLA-compatible (ABOc/HLAc), HLA-incompatible (ABOc/HLAi), ABO-incompatible (ABOi/HLAc), and ABO-incompatible and HLA-incompatible (ABOi/HLAi). Cox proportional hazards regression analyses were carried out to evaluate the risk factors of acute rejection. Out of the 1732 patients who underwent KT, 1190, 131, 358, and 53 were in the ABOc/HLAc, ABOi/HLAc, ABOc/HLAi, and ABOi/HLAi groups, respectively. RESULTS The ABO/HLAi group showed the lowest 5-year graft survival rate (91.7%). Death-censored graft survival was not significantly different among the groups. The mortality rate from infections was significantly higher in the ABOi/HLAi group (7.5%) than the other groups. Antibody-mediated rejection-free graft survival was the lowest in the ABOi/HLAi group, with significant differences compared with the ABOi/HLAc group (P=0.02) and the ABOc/HLAi group (P=0.03). ABOi/HLAi (hazard ratio [HR], 2.63; 95% confidence interval [CI], 1.04-6.65; P<0.01) and combined infection (HR, 1.91; 95% CI, 1.45-2.51; P<0.01) were significant risk factors for acute rejection. CONCLUSIONS Patients with both ABO and HLA incompatibilities showed inferior rates of overall patient and graft survival due to infectious complications. Infection was a prominent risk factor of acute rejection following KT after adjusting for possible confounders including ABO and HLA incompatibility.
Topics: ABO Blood-Group System; Adult; Blood Group Incompatibility; Female; Graft Rejection; HLA Antigens; Humans; Infections; Kidney Transplantation; Living Donors; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Survival Rate; Treatment Outcome
PubMed: 33020465
DOI: 10.12659/AOT.927420 -
Comparative Medicine Aug 2020To determine the incidence of ex vivo incompatibility between ovine maternal RBCs and fetal plasma, we performed cross-matching of blood samples from ewes and from lambs...
To determine the incidence of ex vivo incompatibility between ovine maternal RBCs and fetal plasma, we performed cross-matching of blood samples from ewes and from lambs delivered by cesarean section. Twenty-one date-mated singleton pregnant Merino ewes were anesthetized for cesarean delivery of the fetus. At the time of delivery, paired maternal and fetal blood samples were collected and subsequently separated for storage as packed red blood cells and fresh frozen plasma. Gel column major cross matching was performed within 2 wk. All fetus-dam crossmatches were major crossmatches, combining fetal (recipient) plasma with dam (donor) RBCs. 172 individual dam-dam cross matches were performed. Two of these tests were incompatible (1.2%). In addition, 19 fetal blood samples collected immediately after cesarean delivery were crossmatched with 21 maternal samples to generate 174 maternal-fetal individual cross matches. No maternal-fetal incompatibility reactions were observed. The results of this study demonstrate that all maternal donors and fetal recipients were compatible. In addition, the incidence of an incompatible crossmatch between adult ewes was 1.2%. These data suggest that lambs may not be born with antibodies against other blood types, but rather may acquire such antibodies at some time during early life. In addition, these data suggest the risk of incompatibility reactions between ewes of a similar breed and from a single farm of origin is very low.
Topics: Animals; Blood Group Incompatibility; Blood Grouping and Crossmatching; Cesarean Section; Female; Fetal Blood; Pregnancy; Sheep
PubMed: 32727639
DOI: 10.30802/AALAS-CM-19-000115 -
Canadian Family Physician Medecin de... Jul 2020To provide family physicians with an understanding of blood bank tests performed during pregnancy. The value of routine blood type and antibody tests, as well as the... (Review)
Review
OBJECTIVE
To provide family physicians with an understanding of blood bank tests performed during pregnancy. The value of routine blood type and antibody tests, as well as the follow-up required when a patient develops a red blood cell antibody or experiences a fetal-maternal hemorrhage (FMH) will be reviewed.
SOURCES OF INFORMATION
The approach described is based on the authors' clinical expertise and peer-reviewed literature from 1967 to 2020.
MAIN MESSAGE
An ABO and RhD group and antibody screen test is performed on every pregnant patient during the first trimester. Although antibodies to red blood cell antigens occur infrequently, some can lead to substantial adverse fetal or neonatal consequences including hemolytic disease of the fetus and newborn. Early identification and quantification of important antibodies ensures that at-risk mothers are referred to and followed by obstetricians experienced with high-risk care. Another valuable and related test is the FMH test. For RhD-negative women, these tests are performed at every delivery and following antepartum events that could contribute to FMH. This test determines the number of fetal red blood cells in the maternal circulation and is used to determine the dose of Rh immune globulin an RhD-negative mother requires to prevent alloimmunization to fetal RhD.
CONCLUSION
An understanding of blood bank tests performed during pregnancy and their role and limitations is vital to optimal practice and aids clinicians in their decision making. When there is doubt or confusion regarding antenatal testing or immunoprophylaxis, consult the regional laboratory or transfusion medicine specialists for additional guidance.
Topics: Erythrocytes; Female; Fetomaternal Transfusion; Humans; Infant, Newborn; Isoantibodies; Pregnancy; Rh Isoimmunization; Rho(D) Immune Globulin
PubMed: 32675093
DOI: No ID Found -
Cureus Oct 2022Background The immunoglobulin G of mothers with O blood type may sensitize the platelets of their neonates with A (O-A incompatibility) or B (O-B incompatibility) blood...
Background The immunoglobulin G of mothers with O blood type may sensitize the platelets of their neonates with A (O-A incompatibility) or B (O-B incompatibility) blood type. As the expression and antigenicity of the B antigen on platelets is less than that of the A antigens, we have hypothesized that platelet count is higher in the O-B incompatibility group compared to the O-A incompatibility group. There is controversy about whether glucose-6-phosphate dehydrogenase (G6PD) deficiency, without evidence of hemolysis, is associated with a lower platelet count than G6PD-normal. Aim To assess whether platelet count is higher in the O-B than in the O-A incompatible neonates and whether it correlates with their G6PD levels. Methods This study was a retrospective cohort study on a sample of 835 healthy neonates born at ≥38 weeks gestation who were either A or B blood types with mothers that carried the blood type O Rh-positive. The platelet count (thousand per microliter) from umbilical cord venous blood (UCVB) was used. A G6PD level of 11.0 units/gram of hemoglobin (U/g Hb) was considered the lower reference limit. G6PD deficiency was defined as a G6PD level of <3.3 U/g Hb in both sexes. Intermediate G6PD deficiency in females was described as a G6PD level of 3.3-8.8 U/g Hb. Results The mean UCVB platelet count was higher in female neonates compared to male neonates (n=389, 283±65 versus n=446, 272±73, p=0.01). The mean UCVB platelet count was higher in the O-B incompatibility group in both male (n=114, 291±82 versus n=103, 266±63) and female neonates (n=83, 303±66 versus n=81, 278±58) with G6PD levels of >8.8 U/g Hb. There was a positive weak correlation between UCVB platelet counts and G6PD levels only in O-B incompatible female neonates (n=176, r=0.23, p=0.002). The partitioning and combined 95% reference intervals (RIs) of the UCVB platelet count were presented. Conclusion The platelet count was higher in the O-B incompatibility group compared to the O-A incompatibility group, but only when the G6PD level was >8.8 U/g Hb. A correlation between UCVB platelet count and G6PD levels was found only among O-B incompatible female neonates. These findings may have an important implication in estimating RIs of the UCVB platelet count, however, they need to be confirmed and explored in future research.
PubMed: 36407223
DOI: 10.7759/cureus.30284