BACKGROUND: The frequencies and distributions of unexpected antibodies have been reported using two different criteria, based on either number of persons tested or number of tests performed. But there has been no study that compared the results of analyses based on these two different criteria using the same data set. METHODS: Unexpected antibody tests performed in a University Hospital during recent 6 yr (January 2002-December 2007) were retrospectively analyzed: 76,985 tests (59,503 persons) for screening and 875 tests (749 persons) for identification. Data were analyzed using two different criteria, based on 'persons tested' and 'tests performed'. Antibodies had been screened and identified using LISS/Coombs gel cards with DiaMed-ID system (DiaMed AG, Switzerland). RESULTS: Frequencies of unexpected antibodies based on 'persons tested' and 'tests performed' were 1.32% and 1.34%, respectively (P=0.88). For frequently detected as well as rarely detected antibodies, there were no significant differences in the frequencies based on two different criteria. However, for rarely detected antibodies (anti-Xg(a) and Anti-E & D), the frequencies based on 'tests performed' were higher than those based on 'persons tested', affecting a change in the order of frequencies of antibodies detected. CONCLUSIONS: As there were no significant differences in the frequencies of unexpected antibodies calculated using two different criteria, both criteria can be used together for the patient population in our hospital. However, two criteria should be compared to validate the results for other populations.
Blood Group Antigens/*immunology ; Data Interpretation, Statistical ; Humans ; Isoantibodies/blood/*immunology ; Retrospective Studies

Anti-H antibody belongs to IgM type cold antibody, which often induces the unconformity of positive and reverse typing and leads to the difficulty in clinical blood typing. Anti-H antibody was found during identification of the counter blood group in 3 cases. The antibody was found to be active at 37 degrees C, room temperature and 4 degrees C when determined by blood group serology, and was finally analyzed to be IgM. It is suggested that not to give erythrocytes of O group unreasoningly to blood recipient of AB group during emergent moment, but instead, to give same type of blood. If there was no same type of blood during urgent events, O type erythrocytes could be employed after being matched by saline centrifuging with host side coincidence and screened by incomplete method. In this case, anti-H antibody leading to adverse-reaction in blood transfusion should be prevented.
ABO Blood-Group System ; immunology ; Adult ; Blood Grouping and Crossmatching ; Female ; Humans ; Isoantibodies ; blood ; Male ; Middle Aged

The specificity of the antigens and length of preservation time of erythrocytes are the interfering factors in blood group serological tests. In order to clarify the influence of preservation time of erythrocytes on the blood matching test, the titers of anti-D antibody were detected with papain method, BioVue cross matching card and DianaGel cross matching card in 7 series of panel red blood cells preserved for various length of time (0 to 9 months). The results showed that the titer of micro-column gel test (DianaGel card) was one tube higher than that of column agglutinating test (BioVue card). The titer of erythrocytes preserved for 9 months was as high as 256 tested by DianaGel card, but it was only 2 by papain method in the same anti-serum. It is suggested that there was no obvious difference between the results of micro-column gel test and column agglutinating test, and titer of papain method was the lowest.
Blood Grouping and Crossmatching ; Blood Preservation ; Erythrocytes ; immunology ; Humans ; Isoantibodies ; blood ; Rho(D) Immune Globulin ; Time Factors

OBJECTIVETo investigate the correlation between the platelet GP specific antibodies/HLA antibodies and platelet transfusion refractoriness (PTR).

METHODSSixty-five patients with PTR were selected in this study and were genotyped for HLA-A and HLA-B as well as HPA systems by standard PCR-SSP assays. The platelet GP specific antibodies and HLA antibodies in serum and platelet elution were tested with a solid phase ELISA.

RESULTSThe HLA-A/B antigens and the frequencies of HPA-1, 2, 4, 5, 6, 9, 15 antigens in PTR patients had no difference from those in healthy donors. The freguencies of HPA-3a and 3b were 0.65 and 0.35, respectively. There was statistical difference between the 65 PTR patients and the healthy donors in HPA-3 freguencies (P < 0.05). Twenty-four patients (36.9 %) only expressed HLA antibodies, and 14 (21.5%) expressed HLA and platelet GP specific antibodies. The highest expression of anti-HLA-A/B specific antibodies was -A*9(46.2 %)/-B*40(33.6%), respectively. In serum, GPIIb/IIIa was expressed (26.2%), followed by GPIa/IIa (21.5 %). In platelet elution, GPIIb/IIIa was expressed of 41.5% and GPIb/IX 41.5%. Pedigree study was carried out for 2 patients. The results showed that the platelet GP specific antibody/HLA antibody developed in PTR patients was highly related to the mismatch with the platelet antigen/HLA antigen in their parents.

CONCLUSIONThe expressions of the HLA and platelet GP specific antibodies are the most important reason in PTR, it's meaningful to explore the correlation between PTR and HLA and HLA-A/B antigen in guiding platelet transfusion.

The objective of study was to investigate the Rh antigen stability of mPEG-modified RBC. RBC membrane protein SDS-PAGE technology was used to analyze the combination of the mPEG modified RBC membrane protein with mPEG molecules; the RBC ghost coagulation test and 4 degrees C CPD-preserved modified RBC mixed with matched blood were used to observe the stability of RBC Rh antigen camouflaged by mPEG. The results showed that the blood groups of stored mPEG-modified RBC were kept consistency before or after simulating transfusion, i.e. mixture of modified RBC with matched bloods, while the plasma hemoglobin after simulating transfusion was not only within the normal range during the storage, but also less than that before simulating transfusion even after incubation at 37 degrees C. The electrophoresis pattern stained with iodine and Coomassie blue displayed the bands of mPEG combined with RBC membrane protein and the slow mobility of membrane protein. The hemagglutination of PEGylation RBC ghosts did not take place and mPEG still covered the antigen. In conclusion, mPEG-SPA can bind the erythrocyte with its extracted membrane protein in both ghosts and living erythrocytes.
Erythrocyte Membrane ; immunology ; Erythrocytes ; immunology ; Humans ; Isoantibodies ; blood ; Polyethylene Glycols ; pharmacology ; Rh-Hr Blood-Group System ; immunology ; Transfusion Reaction

OBJECTIVE: To retrospectively analyze the identification results of irregular antibodies, to clarify the distribution features and to explore the relation of alloantibodies and autoantibodies with the immunized history of patients and disease kinds. METHODS: 49 820 patients who applied for red blood transfusion during Sep 1st 2017 to Sep 1st 2018 were selected. All the specimens were screened for the antibody by microcolumn gel antiglobulin technique, which then were identified for irregular antibody. RESULTS: Antibodies were found in 861 (1.73%) of all 49 820 transfused samples. The alloimmunization history of the patients with antibodies was significantly different between male and female (χ=18.54，P＜0.01). The alloantibody was the most common, accounting for 59.50% in all of the antibodies. Warm autoantibody, anti-E, anti-M, anti-cE and anti-Ce accounted for 68.5% of the antibodies. The blood group of Rh, MNS and Lewis were responsible for 92.40% of alloantibody, especially anti-E accounted for the largest percentage(38.60%) of alloantibody. Patients with alloantiboies experienced much more the alloimmunization and transfusion history (χ=20.13，P＜0.01；χ=5.40，P＜0.05) . The distribution of auto and alloantibody was very significantly different among the ddifferent isease (χ=51.8，P＜0.01), Hematopathy, solid tumor and osteoarthropathy were often associated with alloantibody, otherwise, autoantibodies often occurred in hematopathy and autoimmune disease. CONCLUSION The most important factor that results in antibody-screening positive is alloantibody, in which anti-E antibody from Rh blood group system in most common.
Antibodies ; immunology ; Blood Group Antigens ; Blood Transfusion ; Erythrocytes ; Female ; Humans ; Isoantibodies ; Male ; Retrospective Studies

The purpose of this study was to explore the clinical value of the platelet antibody screening and typing in platelets transfusion by using microcolumn gel immunoassay (MGIA). The platelets antigen-antibody reactions including the antibody screen and blood crossmatch were detected by MGIA. The results indicated that the detection of platelet antibody showed positive in 30 cases of aplastic anemia (AA), 11 cases of myelodysplastic syndrome (MDS), 24 out of 25 cases of leukemia and 1 out of cases of other diseases, while detection of platelet antibody showed negative in 20 normal volunteer donors. The number of platelet antibody crossmatch coincidence in 112 specimens of AA, 42 specimens of MDS and 95 specimens of leukemia were 45, 20 and 40, the coincidence rates were 40.18%, 47.62% and 42.11%. The mean corrected count increment (CCI) in 20 patients received platelet transfusion many times was 18.2 after crossmatch and 4.7 before crossmatch. It is concluded that the positive rate of platelet antibody screening is very high in patients with hematologic malignancies, the coincidence rate of platelet antibody crossmatch in 249 blood samples is between 40% and 48%, and the efficiency of using crossmatched platelets in clinic is enhanced significantly.
Anemia, Aplastic ; immunology ; Antigens, Human Platelet ; immunology ; Blood Grouping and Crossmatching ; Blood Platelets ; immunology ; Hematologic Neoplasms ; immunology ; Humans ; Immunoassay ; methods ; Isoantibodies ; blood ; immunology ; Platelet Transfusion ; methods

BACKGROUND: Although single antigen bead assays (SAB) are approved qualitative tests, the median fluorescence intensity (MFI) values obtained from SAB are frequently used in combination with quantitative significances for diagnostic purposes. To gauge the reproducibility of SAB results, we assessed the interlaboratory variability of MFI values using identical kits with reagents from the same lot and the manufacturer's protocol. METHODS: Six serum samples containing HLA-specific antibodies were analyzed at five laboratories by using Lifecodes LSA Class I and Class II SAB kits (Immucor, USA) from the same lot, according to the manufacturer's protocol. We analyzed the concordance of qualitative results according to distinct MFI cutoffs (1,000, 3,000, 5,000, and 10,000), and the correlation of quantitative MFI values obtained by the participating laboratories. The CV for MFI values were analyzed and grouped by mean MFI values from the five laboratories (<1,000; 1,000-2,999; 3,000-4,999; 5,000-9,999; and > or =10,000). RESULTS: The categorical results obtained from the five laboratories exhibited concordance rates of 96.0% and 97.2% for detection of HLA class I and class II antibodies, respectively. The Pearson correlation coefficients for MFI values of class I and class II antibodies were between 0.947-0.991 and 0.992-0.997, respectively. The median CVs for the MFI values among five laboratories in the lower MFI range (<1,000) were significantly higher than those for the other MFI ranges (all P<0.01). CONCLUSIONS: Analysis of SAB performed in five laboratories using identical protocols and reagents from the same lot resulted in high levels of concordance and strong correlation of results.
Analysis of Variance ; HLA Antigens/immunology ; Histocompatibility Testing ; Humans ; Isoantibodies/*blood ; Laboratories ; Reagent Kits, Diagnostic ; Reproducibility of Results

The Kidd blood group is clinically significant since the Jk antibodies can cause acute and delayed transfusion reactions as well as hemolytic disease of newborn (HDN). In general, HDN due to anti-Jk(b) incompatibility is rare and it usually displays mild clinical symptoms with a favorable prognosis. Yet, we apparently experienced the second case of HDN due to anti-Jk(b) with severe clinical symptoms and a fatal outcome. A female patient having the AB, Rh(D)-positive boodtype was admitted for jaundice on the fourth day after birth. At the time of admission, the patient was lethargic and exhibited high pitched crying. The laboratory data indicated a hemoglobin value of 11.4 mg/dL, a reticulocyte count of 14.9% and a total bilirubin of 46.1 mg/dL, a direct bilirubin of 1.1 mg/dL and a strong positive result (+++) on the direct Coomb's test. As a result of the identification of irregular antibody from the maternal serum, anti-Jk(b) was detected, which was also found in the eluate made from infant's blood. Despite the aggressive treatment with exchange transfusion and intensive phototherapy, the patient died of intractable seizure and acute renal failure on the fourth day of admission. Therefore, pediatricians should be aware of the clinical courses of hemolytic jaundice due to anti-Jk(b), and they should be ready to treat this disease with active therapeutic interventions.
Bilirubin/blood ; Erythroblastosis, Fetal/*blood ; Fatal Outcome ; Female ; Humans ; Infant, Newborn ; Isoantibodies/blood ; Kidd Blood-Group System/*immunology

We report a case of two consecutive episodes of acute hemolytic transfusion reactions (HTRs) due to multiple alloantibodies in a 34-yr-old man who suffered from avascular necrosis of left femoral head. He received five units of packed red blood cells (RBCs) during surgery. Then the transfusion of packed RBCs was required nine days after the surgery because of the unexplained drop in hemoglobin level. The transfusion of the first two units resulted in fever and brown-colored urine, but he received the transfusion of another packed RBCs the next day. He experienced even more severe symptoms during the transfusion of the first unit. We performed antibody screening test, and it showed positive results. Multiple alloantibodies including anti-E, anti-c and anti-Jk(b) were detected by antibody identification study. Acute HTRs due to multiple alloantibodies were diagnosed, and the supportive cares were done for 6 days. We suggest the antibody screening test should be included in the panel of pretransfusion tests for safer transfusion, and it is particularly mandatory for the patients with multiple transfusions, pregnant women, and preoperative patients.
Adult ; Blood Group Antigens/immunology ; *Blood Group Incompatibility ; Blood Grouping and Crossmatching/methods ; Blood Transfusion/*adverse effects ; Female ; Hemolysis/*immunology ; Human ; Isoantibodies/*immunology ; Male ; Pregnancy