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Journal of Laboratory Physicians Mar 2023ABO incompatibility between O blood group mother and non-O blood group neonate is common. It rarely causes anemia and hyperbilirubinemia in neonate, requiring invasive...
ABO incompatibility between O blood group mother and non-O blood group neonate is common. It rarely causes anemia and hyperbilirubinemia in neonate, requiring invasive management. Direct antiglobulin test may be positive in these cases with immunoglobulin (Ig)-G antibody specificity. There are few cases of hemolytic disease of newborn due to ABO incompatibility between mother and newborn with non - O blood group mother. After obtaining consent from the patient, we reported a case of incompatibility in a B blood group mother and A blood group neonate, and it was managed with phototherapy.
PubMed: 37064992
DOI: 10.1055/s-0042-1750071 -
JPMA. the Journal of the Pakistan... Nov 2022Neonatal haemolytic disease in the new-born remains of prime importance for paediatricians due to high perinatal morbidity and mortality rates. The Rh antigen family...
Neonatal haemolytic disease in the new-born remains of prime importance for paediatricians due to high perinatal morbidity and mortality rates. The Rh antigen family comprises several different antigens, out of which, D antigen incompatibility is well known for causing severe haemolytic disease in the foetus. Although the current literature shows anomalous cases where coexisting non-D-Rh and D-Rh antigens are the causative agents, there is very little information regarding post-natal outcomes in neonates bearing two different incompatibilities simultaneously. Herein, we discuss an unusual case of anti-D as well as anti-C antibodies (non-D-Rh) in a male neonate born to a Rh-negative mother, who developed jaundice and haemolysis in post-natal life. The neonate underwent exchange transfusion and photo therapy due to raised serum bilirubin levels, supplemented with repeated blood transfusions, intravenous immunoglobulin therapy, and immunosuppressive therapy. He responded well to the management and was later discharged from the hospital. Long-term follow-up revealed no side-effects.
Topics: Pregnancy; Female; Infant, Newborn; Male; Humans; Erythroblastosis, Fetal; Rho(D) Immune Globulin; Blood Group Antigens; Blood Transfusion
PubMed: 37013314
DOI: 10.47391/JPMA.4564 -
Indian Journal of Hematology & Blood... Apr 2023- Prozone phenomenon due to excess unbound antibodies may sometimes lead to failure of detection of ABO incompatibility. . The case series describes immunohematology...
INTRODUCTION
- Prozone phenomenon due to excess unbound antibodies may sometimes lead to failure of detection of ABO incompatibility. . The case series describes immunohematology work up of blood group discrepancies of two blood donors.
MATERIALS AND METHODS
- Blood grouping was performed by a fully automated immune hematology analyzer (FAIHA Diagast, Qwalys 3, France) based on the principle of erythrocyte magnetized technology. Further immunohematology workup was done by tube technique (at different temperatures and phases) and column agglutination technique (CAT). Antibody titration was done by tube technique at saline and AHG (anti human globulin) phase.
RESULTS
- Type I blood group discrepancy was detected on initial blood grouping done by an automated analyzer. The discrepancy was resolved by repeat blood grouping by tube technique with a remarkable finding of hemolysis in reverse grouping. The lysis was attributed to high titer antibodies (anti-B titer of 512) with demonstration of prozone phenomenon. However, there was no discrepancy between cell and serum grouping by column agglutination technique (CAT).
CONCLUSION
- Tube technique is the gold standard method for blood grouping and detects blood group discrepancies optimally. Hemolysis which is taken as a positive result, can be best appreciated by tube technique.
PubMed: 37006973
DOI: 10.1007/s12288-022-01583-5 -
Transfusion May 2023Due to platelet availability limitations, platelet units ABO mismatched to recipients are often transfused. However, since platelets express ABO antigens and are...
BACKGROUND
Due to platelet availability limitations, platelet units ABO mismatched to recipients are often transfused. However, since platelets express ABO antigens and are collected in plasma which may contain ABO isohemagglutinins, it remains controversial as to whether ABO non-identical platelet transfusions could potentially pose harm and/or have reduced efficacy.
STUDY DESIGN AND METHODS
The large 4-year publicly available Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) database was used to investigate patient outcomes associated with ABO non-identical platelet transfusions. Outcomes included mortality, sepsis, and subsequent platelet transfusion requirements.
RESULTS
Following adjustment for possible confounding factors, no statistically significant association between ABO non-identical platelet transfusion and increased risk of mortality was observed in the overall cohort of 21,176 recipients. However, when analyzed by diagnostic category and recipient ABO group, associations with increased mortality for major mismatched transfusions were noted in two of eight subpopulations. Hematology/Oncology blood group A and B recipients (but not group O) showed a Hazard Ratio (HR) of 1.29 (95%CI: 1.03-1.62) and intracerebral hemorrhage group O recipients (but not groups A and B) showed a HR of 1.75 (95%CI: 1.10-2.80). Major mismatched transfusions were associated with increased odds of receiving additional platelet transfusion each post-transfusion day (through day 5) regardless of the recipient blood group.
DISCUSSION
We suggest that prospective studies are needed to determine if specific patient populations would benefit from receiving ABO identical platelet units. Our findings indicate that ABO-identical platelet products minimize patient exposure to additional platelet doses.
Topics: Humans; Platelet Transfusion; Blood Platelets; Retrospective Studies; ABO Blood-Group System; Blood Group Incompatibility; Transfusion Reaction
PubMed: 36994786
DOI: 10.1111/trf.17319 -
Journal of Perinatology : Official... Nov 2023We analyze phototherapy rates after implementation of a Hyperbilirubinemia Clinical Pathway (HCP), which placed full-term ABOi DAT negative newborns on the low risk...
OBJECTIVE
We analyze phototherapy rates after implementation of a Hyperbilirubinemia Clinical Pathway (HCP), which placed full-term ABOi DAT negative newborns on the low risk phototherapy nomogram, rather than medium risk, as previously done.
STUDY DESIGN
A chart review was performed for ABOi newborns born ≥36 weeks gestation between January 2020 and October 2021. Primary outcome measures were rates of phototherapy across pre- and post-intervention groups and among DAT negative newborns.
RESULTS
There was an increased proportion of newborns assigned to the low risk curve after the intervention. There were no significant differences in phototherapy rates among the intervention groups, although there was a non-significant decrease in phototherapy rates among DAT negative newborns after the intervention. There were no increases in adverse outcomes.
CONCLUSIONS
Providers adhered to the guidelines after implementation of the HCP. ABOi DAT negative newborns can be viewed as low risk for hyperbilirubinemia requiring phototherapy.
Topics: Female; Humans; Infant, Newborn; Erythroblastosis, Fetal; Coombs Test; Hyperbilirubinemia; Blood Group Incompatibility; Phototherapy
PubMed: 36959468
DOI: 10.1038/s41372-023-01650-3 -
Indian Pediatrics Mar 2023
Topics: Humans; Rh Isoimmunization; Iron Overload
PubMed: 36916367
DOI: No ID Found -
Blood Research Apr 2023Transfusion support for hematopoietic stem cell transplantation (HSCT) is an essential part of supportive care, and compatible blood should be transfused into... (Review)
Review
Transfusion support for hematopoietic stem cell transplantation (HSCT) is an essential part of supportive care, and compatible blood should be transfused into recipients. As leukocyte antigen (HLA) matching is considered first and as the blood group does not impede HSCT, major, minor, bidirectional, and RhD incompatibilities occur that might hinder transfusion and cause adverse events. Leukocyte reduction in blood products is frequently used, and irradiation should be performed for blood products, except for plasma. To mitigate incompatibility and adverse events, local transfusion guidelines, hospital transfusion committees, and patient management should be considered.
PubMed: 36843378
DOI: 10.5045/br.2023.2023004 -
Cirugia Y Cirujanos 2023To demonstrate the experience since the transplant program under paired kidney donation implementation; program that increases the donation rate by 25-30% in hospitals... (Observational Study)
Observational Study
OBJECTIVE
To demonstrate the experience since the transplant program under paired kidney donation implementation; program that increases the donation rate by 25-30% in hospitals with no inferior graft survival compared to directed living donor kidney transplantation.
METHOD
Observational, analytical, longitudinal and prospective study from December 2018 to July 2021. All G5 KDIGO chronic kidney patients who were HLA or ABO incompatible with their original donors in the pretransplant protocol and who were transplanted under the paired kidney donation program, were included.
RESULTS
22 kidney transplants were performed under this program. Survival of the graft and the patient 1 year after transplantation was 100%. The post-transplant glomerular filtration rate was 72.5 ± 17 ml/min/1.73 m body surface. 36.3% of hypersensitized patients were successfully transplanted. The in-hospital donation rate increased by 33.33%.
CONCLUSIONS
Transplantation under the kidney paired donation program constitutes a real modality of successful transplantation when there is incompatibility with the original donor. The greater use and socialization of this program can increase the country kidney transplantation rate, reducing the waiting list. Our hospital represents the largest experience published in Mexico with this transplant program.
Topics: Humans; Blood Group Incompatibility; Kidney; Kidney Transplantation; Prospective Studies; Tissue Donors
PubMed: 36787598
DOI: 10.24875/CIRU.21000865 -
American Journal of Transplantation :... Apr 2023ABO compatibility is important for kidney transplantation, with longer waitlist times for blood group B kidney transplant candidates. However, kidneys from non-A (eg, A)...
ABO compatibility is important for kidney transplantation, with longer waitlist times for blood group B kidney transplant candidates. However, kidneys from non-A (eg, A) subtype donors, which express less A antigen, can be safely transplanted into group B recipients. ABO subtyping is routinely performed using anti-A lectin, but DNA-based genotyping is also possible. Here, we compare lectin and genotyping testing. Lectin and genotype subtyping was performed on 554 group A deceased donor samples at 2 transplant laboratories. The findings were supported by 2 additional data sets of 210 group A living kidney donors and 124 samples with unclear lectin testing sent to a reference laboratory. In deceased donors, genotyping found 65% more A donors than lectin testing, most with weak lectin reactivity, a finding supported in living donors and samples sent for reference testing. DNA sequencing and flow cytometry showed that the discordances were because of several factors, including transfusion, small variability in A antigen levels, and rare ABO∗A2.06 and ABO∗A2.16 sequences. Although lectin testing is the current standard for transplantation subtyping, genotyping is accurate and could increase A kidney transplant opportunities for group B candidates, a difference that should reduce group B wait times and improve transplant equity.
Topics: Humans; Kidney Transplantation; Genotype; Blood Group Incompatibility; Tissue Donors; Living Donors; ABO Blood-Group System; Isoantibodies
PubMed: 36732087
DOI: 10.1016/j.ajt.2022.12.017 -
American Journal of Transplantation :... Mar 2023Living donor liver transplantation is an effective means to decrease organ shortage. However, many potential living donors are currently being denied due to ABO...
Living donor liver transplantation is an effective means to decrease organ shortage. However, many potential living donors are currently being denied due to ABO incompatibility or inadequate donor liver volume. Liver paired exchange (LPE) provides a practical solution to overcome these obstacles, and yet the first case of LPE in the United States was only recently reported in 2020. Here, we report world's first case of LPE involving pediatric and adult recipients to avoid surgical complexity of the pediatric recipient and to increase the graft-to-recipient weight ratio of the adult recipient between 2 ABO compatible pairs. As living donor liver transplantation becomes more widely adopted, the need for pair exchange to improve surgical safety and postoperative outcomes between 2 ABO compatible pairs is likely to increase.
Topics: Humans; Adult; Child; United States; Liver Transplantation; Living Donors; Liver; Blood Group Incompatibility; Kidney Transplantation; ABO Blood-Group System
PubMed: 36695680
DOI: 10.1016/j.ajt.2022.10.008