Transfusion of incompatible RBCs to a patient with alloanti-Kp(b).
BACKGROUND
The finding of an antibody that reacts against a high-incidence blood group antigen always constitutes a complex transfusion problem because of the difficulty in finding compatible units. When the transfusion of incompatible RBCs is imperative, it would be of great interest to have access to techniques facilitating the prediction of the transfusion outcome.


METHODS
The case of a patient with alloanti-Kp(b) who required RBC transfusions is reported. The functional activity of this antibody was assessed by both the chemiluminescence test (CLT) and the survival of 51Cr-labeled RBCS:


RESULTS
The CLT showed an opsonic index of 0.8 with Kp(b)-positive RBCs (normal values up to 1.6) in pretransfusion studies. During an elective surgical procedure, the patient required the transfusion of one incompatible unit of RBCs, which did not produce hemolysis. Two weeks after this incompatible transfusion, the opsonic index had risen to 11. Results of the 51Cr in vivo study, also performed at that time, indicated 24.3 percent survival of Kp(b)-positive RBCs at 60 minutes and 2.0 percent at 24 hours.


CONCLUSIONS
Results of the CLT correlated with the in vivo transfusion outcome and later with the 51Cr survival study.
Mazzara
R
R
Department of Hemotherapy and Hemostasis, the Institut de Malalties Digestives, Barcelona, Spain. rmazzara@medicina.ub.es
Lozano
M
M
Salmerón
J M
JM
Piera
C
C
Ribera
A
A
Mas
A
A
Ordinas
A
A
D017707:Erythrocyte Transfusion; D006801:Humans; D007518:Isoantibodies / Q000276:immunology*; D007626:Kell Blood-Group System / Q000276:immunology*; D008163:Luminescent Measurements
D007518:Isoantibodies; D007626:Kell Blood-Group System