title: Selection of GP. Mur antigen-negative RBC for blood recipients with anti-'Mia' records decreases transfusion reaction rates in Taiwan.
abstract: OBJECTIVE
  To evaluate the clinical significance of GP. Mur antigen-negative blood selection for transfusion in patients with anti-'Mia' records.
  
  
  BACKGROUND
  The GP. Mur RBC phenotype is prevalent (7·3%) in Taiwan. Antibodies against GP. Mur (anti-'Mia') are identified in 1·24% of our population, and anti-'Mia' screening using GP. Mur RBC has been routine for Taiwan's blood banks. However, due to the lack of commercial antibodies, only cross-matching was used to prevent transfusion of GP. Mur-positive blood to patients with anti-'Mia' in most hospitals. There is still a risk of GP. Mur-positive RBC exposure and subsequent anti-'Mia'-related transfusion reactions.
  
  
  METHODS
  Since February 2014, GP. Mur antigen-negative RBCs identified by reaction with anti-'Mia'-positive serum were selected for blood recipients with anti-'Mia' records. The transfusion reactions between January 2013 and January 2014 were compared with those that occurred between February 2014 and July 2015.
  
  
  RESULTS
  The transfusion reaction rate was significantly higher in anti-'Mia'-positive blood recipients compared to total subjects receiving an RBC transfusion before GP. Mur-negative donor RBC selection. After antigen-negative RBC selection, the transfusion reaction frequency in subjects with anti-'Mia' became similar to total blood recipients. IgG form anti-'Mia' antibodies were present in all cases of probable anti-'Mia'-related transfusion reactions. The time required for anti-'Mia' boosting after transfusion was around 4-21 days.
  
  
  CONCLUSIONS
  Selection of GP. Mur-negative RBC for transfusion to patients with anti-'Mia' records could decrease the rate of transfusion reaction and antibody boosting. This procedure should be incorporated into blood bank routines in areas where anti-'Mia' is prevalent.
authors.affiliation: Department of Laboratory Medicine, China Medical University Hospital, Taiwan, China.|College of Medicine, China Medical University, Taiwan, China.|Division of General Pediatrics, Children's Hospital of China Medical University, Taichung City, China.
authors.forename: C-A
authors.initials: CA
authors.lastname: Yang
authors.affiliation: Department of Laboratory Medicine, China Medical University Hospital, Taiwan, China.
authors.forename: J-A
authors.initials: JA
authors.lastname: Lin
authors.affiliation: Department of Laboratory Medicine, China Medical University Hospital, Taiwan, China.
authors.forename: C-W
authors.initials: CW
authors.lastname: Chang
authors.affiliation: Division of Pediatric Hematology-Oncology, Children's Hospital, Taiwan, China.|School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taiwan, China.
authors.forename: K-H
authors.initials: KH
authors.lastname: Wu
authors.affiliation: College of Medicine, China Medical University, Taiwan, China.|Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taiwan, China.
authors.forename: S-P
authors.initials: SP
authors.lastname: Yeh
authors.affiliation: Department of Laboratory Medicine, China Medical University Hospital, Taiwan, China.|Department of Nursing, Hungkuang University, Taiwan, China.
authors.forename: C-M
authors.initials: CM
authors.lastname: Ho
authors.affiliation: Department of Laboratory Medicine, China Medical University Hospital, Taiwan, China. d6781@mail.cmuh.org.tw.|College of Medicine, China Medical University, Taiwan, China. d6781@mail.cmuh.org.tw.|Epigenome Research Center, China Medical University Hospital, Taiwan, China. d6781@mail.cmuh.org.tw.
authors.forename: J-G
authors.initials: JG
authors.lastname: Chang
mesh_terms: D001782:Blood Donors; D001789:Blood Group Antigens / Q000097:blood*; D001788:Blood Grouping and Crossmatching / Q000379:methods*; D046148:Donor Selection / Q000379:methods*; D004912:Erythrocytes / Q000166:cytology / Q000378:metabolism*; D005260:Female; D006021:Glycophorins / Q000378:metabolism*; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D008297:Male
chemical_list: D001789:Blood Group Antigens; D006021:Glycophorins; D007518:Isoantibodies; C068315:Miltenberger III-like molecule glycophorin variant
keywords: GP. Mur; Miltenberger type III; anti-‘Mia’; antibody boosting; transfusion reaction