Estimation of combat-related blood group alloimmunization and delayed serologic transfusion reactions in U.S. military veterans.
The goals of this study were to estimate blood group alloimmunization arising from combat-related transfusion and the prevalence of delayed serologic transfusion reactions (DSTRs) in military veteran patients. Blood group alloantibodies documented in the transfusion records at a Veterans Affairs (VA) medical center were categorized according to whether they developed before ("pre-existing") or during ("hospital-acquired") VA care and whether they were associated with anamnestic immune responses. Combat-related alloantibodies were estimated by adding anamnestic to pre-existing antibodies, revealing that 256 veterans made 322 combat-related alloantibodies. The combat-related alloimmunization rate was 1.37% (256/18,750), and combat-related alloantibodies represented 55.8% (322/577) of total alloantibodies. The highest rate of combat-related alloimmunization was observed in World War II-era veterans. Approximately 11.2% (25/224) of veterans with hospital-acquired antibodies experienced a DSTR due to prior alloimmunization. In conclusion, combat-related alloimmunization accounted for more than half of antibodies in military veterans and was a predisposing factor for DSTRs.
Tormey
Christopher A
CA
Pathology and Laboratory Medicine Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, USA.
Stack
Gary
G
D001789:Blood Group Antigens / Q000276:immunology; D001788:Blood Grouping and Crossmatching; D016009:Chi-Square Distribution; D003130:Combat Disorders / Q000097:blood* / Q000150:complications* / Q000276:immunology; D005260:Female; D006801:Humans; D007154:Immune System Diseases / Q000097:blood* / Q000209:etiology* / Q000276:immunology; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D065227:Transfusion Reaction; D014481:United States; D014728:Veterans
D001789:Blood Group Antigens; D007518:Isoantibodies