[Blood transfusion and pretransfusion testing in patients with warm autoimmune haemolytic anaemia].
BACKGROUND
In warm autoimmune haemolytic anaemia, patients have red cell autoantibodies that complicate the serological compatibility testing before transfusion. Different autoadsorption techniques are utilised for more extensive pretransfusion testing. We reviewed the literature on blood transfusion in these patients. We also present our experience with autoadsorption by papain and polyethylene glycol methods.


METHODS
Blood samples from 13 patients with warm autoantibodies were analysed in parallel. After autoadsorption, antibody screening and identification tests were performed to detect possible red cell alloantibodies. If the serological testing is inadequate, clinically important alloantibodies can be ignored before transfusion, which can lead to haemolytic transfusion reactions.


RESULTS
Autoantibodies were completely adsorbed in six of the 13 patients. In five, alloantibodies were detected. In three patients, different results were obtained with the two different techniques.


CONCLUSIONS
Restrictive transfusion practice in warm autoimmune haemolytic anaemia is recommended. Adequate pretransfusion testing in a specialised laboratory is required before transfusion. Autoadsorption with polyethylene glycol and papain can supplement each other in pretransfusion testing.
Melve
Guro Kristin
GK
Blodbanken, Haukeland Universitetssjukehus, 5021 Bergen. guro.kristin.melve@helse-bergen.no
Hervig
Tor
T
Øvrebøe
Ragnhild
R
Nesthus
Ingerid
I
D000327:Adsorption; D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D001803:Blood Transfusion; D006801:Humans; D007163:Immunosorbent Techniques; D007518:Isoantibodies / Q000097:blood / Q000276:immunology; D010206:Papain; D011092:Polyethylene Glycols; D065227:Transfusion Reaction
D001323:Autoantibodies; D007518:Isoantibodies; D011092:Polyethylene Glycols; D010206:Papain