title: Antibody screening & identification in the general patient population at a tertiary care hospital in New Delhi, India.
abstract: OBJECTIVE
  The development of alloantibodies can significantly complicate transfusion therapy and results in difficulties in cross-matching of blood. Most literature on alloimmunization is limited to multitransfused individuals, with very few studies on the general hospital patients. This study was aimed at assessing the frequency and type of unexpected red cell antibodies in the general patient population at a multispecialty tertiary care centre in New Delhi, India.
  
  
  METHODS
  The results of 49,077 antibody screening tests carried out on patients, from January 2009 to December 2012 were analyzed. The clinical and transfusion records were reviewed. The data were compiled and statistically analysed.
  
  
  RESULTS
  A total of 49,077 (29,917; 60.96% males and 19,160; 39.04% females) patient samples were screened for the presence of unexpected antibodies. Antibody screening was positive in 403 patients (0.82%). In the serum samples of 164 patients only autoantibodies were identified, 27 revealed autoantibodies with one or more underlying alloantibodies, while 212 patients had only alloantibody/ies in their serum. The overall alloimmunization rate was 0.49 per cent. Antibodies against the Rh system were the most frequent (64.1%), the most common alloantibody identified being anti E (37.2%), followed by anti D (19.2%).
  
  
  CONCLUSIONS
  Since clinically significant antibodies are frequently detected in our patient population, antibody screening and if required, identification is the need of the hour. Since antibodies against the common Rh and Kell blood group antigens are the most frequent, provision of Rh and Kell matched red cells may be of protective value.
authors.affiliation: Department of Transfusion Medicine, Indraprastha Apollo Hospitals, New Delhi, India.
authors.forename: Raj Nath
authors.initials: RN
authors.lastname: Makroo
authors.forename: Aakanksha
authors.initials: A
authors.lastname: Bhatia
authors.forename: Vikas
authors.initials: V
authors.lastname: Hegde
authors.forename: Mohit
authors.initials: M
authors.lastname: Chowdhry
authors.forename: Uday Kumar
authors.initials: UK
authors.lastname: Thakur
authors.forename: N L
authors.initials: NL
authors.lastname: Rosamma
mesh_terms: D001789:Blood Group Antigens / Q000276:immunology; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007194:India; D007518:Isoantibodies / Q000097:blood / Q000276:immunology* / Q000302:isolation & purification; D007626:Kell Blood-Group System / Q000276:immunology*; D008297:Male; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D018029:Rho(D) Immune Globulin; D062606:Tertiary Care Centers
chemical_list: D001789:Blood Group Antigens; D007518:Isoantibodies; D007626:Kell Blood-Group System; C061961:RHO(D) antibody; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin