Irradiation of Red Blood Cells and Alloimmunization.
BACKGROUND
Animal models suggest that red blood cell (RBC) damage incurred during storage can increase immunogenicity to some RBC antigens. We hypothesized that RBC irradiation, a source of oxidative damage, may result in higher RBC alloimmunization rates among transfusion recipients.


METHODS
Individuals receiving 1 or more gamma-irradiated RBC units, with follow-up antibody screening, were studied. We recorded diagnosis at the time of first irradiated RBC-unit transfusion, total irradiated RBCs received, and alloantibodies detected before and after irradiated RBC transfusion.


RESULTS
The alloimmunization rate for patients receiving irradiated RBCs was 1.9% (3/154); this rate was not significantly different from the rate of 2.5% (5/200) derived from a control group that had undergone transfusion with nonirradiated RBCs ( P  > .99). Most of the study subjects (83/154 [53.9%]) did not harbor an immunosuppressive disorder at the time of transfusion of irradiated RBCs, with postoperative bleeding (36/83 [43.4%]) being the most common diagnosis.


CONCLUSIONS
This analysis provides reassurance that irradiated RBCs are not more immunogenic in patients with immunosuppression than in patients with immunocompetence.
Pathology and Laboratory Medicine Service, VA Connecticut Healthcare System, West Haven, CT.|Departments of Laboratory Medicine.
Christopher A
CA
Tormey
Departments of Laboratory Medicine.|Pediatrics, Yale University School of Medicine, New Haven, CT.
Jeanne E
JE
Hendrickson
D000368:Aged; D016913:Blood Component Transfusion / Q000706:statistics & numerical data*; D001793:Blood Preservation / Q000009:adverse effects*; D015331:Cohort Studies; D004912:Erythrocytes / Q000276:immunology / Q000528:radiation effects; D005260:Female; D005720:Gamma Rays; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D008297:Male; D011827:Radiation
D007518:Isoantibodies
alloantibody responders; alloimmunization; blood group alloantibodies; blood group antigens; blood product irradiation; immunohematology