Abstract
In 1978, a chronic transfusion program was initiated for selected SSA patients using donors closely matched for 17 RBC antigens (C,D,c,E,ē,Kell,P,M,N,S,s,Fya,Fyb,Jka,Jkb,Lea,Leb) because isoimmunization is common in black patients receiving random donor transfusions (34% in our population). This is due to the high frequency of negativity for certain minor RBC antigens (e.g. C,E,Fya,Fyb,Leb) in blacks and the likelihood of positivity for these antigens in Caucasians. Twelve patients who had received multiple previous “unmatched” random donor transfusions were then given 1-3 units of “matched” RBCs every 3 weeks over a period of 7-70 mo. Each patient was matched as closely as possible with 8-30 donors selected from over 1000 genotyped blacks.
With multiple “unmatched” donors, the risk of antibody development per transfusion was 3.7% in contrast to 0.3% with “matched” donors. Two of the 3 “matched” patients with new antibodies (C,Kell;C) had presented difficulties in the initial genotype. Thus, only 1 patient had 1 new antibody (KAP) when matched strictly by protocol. Our data shows that matching for certain minor RBC antigens reduces isoimmunization in SSA patients.
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Ambruso, D., Githens, J., Ruder, L. et al. FIVE YEARS' EXPERIENCE WITH CHRONIC TRANSFUSIONS IN SICKLE CELL ANEMIA (SSA) USING DONORS MATCHED FOR MINOR RBC ANTIGENS. Pediatr Res 18 (Suppl 4), 235 (1984). https://doi.org/10.1203/00006450-198404001-00854
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DOI: https://doi.org/10.1203/00006450-198404001-00854