title: Transfusion support of autoimmune hemolytic anemia: how could the blood group genotyping help?
abstract: Conventional pretransfusion testing based on hemagglutination assays can be challenging for patients with autoimmune hemolytic anemia (AIHA) because of the presence of auto-antibodies. It has been suggested that deoxyribonucleic acid-based methods could be more efficient in the selection of antigen-matched red blood cell units in those settings. Because of the high risk of alloimmunization of these patients and the labor-intensive nature of adsorption techniques, we decided to evaluate the feasibility of selecting antigen-matched units on the basis of RBC genotyping. We included in our routine RBC genotyping program samples from 7 patients with AIHA presenting a strongly positive direct antiglobulin test. This made the routine compatibility tests difficult. Most patients had previously received transfusions because of warm AIHA. Matched donor units were selected according to the genotype. For all but 1 patient, blood group genotyping could be done on time to allow antigen-matched transfusion. Four patients received antigen-matched red blood cell units based on RBC genotyping and for 1 patient the fact that no matched units were available led us to postpone the transfusion. After each transfusion, the recovery was recorded and considered satisfactory for all transfused patients.
authors.affiliation: Department of Transfusion, Hospital Blood Bank, CHU-Brugmann and Queen Fabiola Children University Hospital, Brussels, Belgium. Electronic address: hanane.elkenz@chu-brugmann.be.
authors.forename: Hanane
authors.initials: H
authors.lastname: El Kenz
authors.affiliation: Department of Hematology, CHU-Brugmann, Brussels, Belgium.
authors.forename: André
authors.initials: A
authors.lastname: Efira
authors.affiliation: Department of Hematology, Queen Fabiola University Children Hospital, Brussels, Belgium.
authors.forename: Phu Quoc
authors.initials: PQ
authors.lastname: Le
authors.affiliation: Department of Transfusion, Hospital Blood Bank, CHU-Brugmann and Queen Fabiola Children University Hospital, Brussels, Belgium.
authors.forename: Claire
authors.initials: C
authors.lastname: Thiry
authors.affiliation: Laboratory of Clinical Biology, CHU-Brugmann, Brussels, Belgium.
authors.forename: Joseph
authors.initials: J
authors.lastname: Valsamis
authors.affiliation: Department of Hematology, CHU-Brugmann, Brussels, Belgium.
authors.forename: Marie-Agnès
authors.initials: MA
authors.lastname: Azerad
authors.affiliation: Laboratory of Immunology, CHU-Brugmann, Brussels, Belgium.
authors.forename: Francis
authors.initials: F
authors.lastname: Corazza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000744:Anemia, Hemolytic, Autoimmune / Q000628:therapy*; D001789:Blood Group Antigens / Q000235:genetics*; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male
chemical_list: D001789:Blood Group Antigens
keywords: AIHA; DAT; DNA; EDTA; G6PD; INR; International normalized ratio; LISS-IAT; RBCs; autoimmune hemolytic anemia; deoxyribonucleic acid; direct antiglobulin test; ethylenediaminetetraacetic acid; glucose-6-phosphate dehydrogenase; low ionic strength solution-indirect antiglobulin; red blood cells