The risk of alloimmunization to c (Rh4) in R1R1 patients who present with anti-E

R. S. Shirey, Paul Michael Ness, P. M. Ness

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Abstract

Background: Because the Rh antigens E (Rh3) and c (Rh4) are relatively immunogenic, it has been suggested that R1R1 (E-, c-) patients who present with anti-E alone receive prophylactic c- (Rh:-4) red cell transfusions. Study Design and Methods: To determine the utility of this approach, the transfusion records of 100 consecutive R1R1 patients with anti-E identified over a 6-year period were reviewed. Results: Thirty-two (32%) had anti-c concurrent with anti-E. Twenty-seven of the 68 patients who presented with anti-E alone received random (i.e., not typed for c [Rh4]) red cell transfusions. Five (18.5%) of the 27 subsequently developed anti-c 13 to 193 days (mean, 50) after transfusion of 2 to 14 (mean, 8) red cell units. None of the five had clinical evidence of hemolysis that could be attributed to a delayed hemolytic transfusion reaction. Twenty-two (81.5%) of the 27 failed to develop anti-c even after transfusion of 1 to 41 (mean, 9; median, 7) red cell units. Conclusion: The overall rate of immunization to c (Rh4) antigen in R1R1 patients with anti-E was 37 percent. Production of anti-c following transfusion to R1R1 patients with anti-E occurred in 18.5 percent of the cases in this series, which could have been avoided by the prophylactic use of R1R1 (E-, c-) blood for transfusion. The prophylactic use of c- (Rh:-4) blood in this patient population may be justified by the high immunization rate and the potential risk of delayed hemolytic transfusion reaction.

Original languageEnglish (US)
Pages (from-to)756-758
Number of pages3
JournalTransfusion
Volume34
Issue number9
StatePublished - 1994

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Immunization
Antigens
Hemolysis
Blood Transfusion
Population
Transfusion Reaction

ASJC Scopus subject areas

  • Immunology
  • Hematology

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The risk of alloimmunization to c (Rh4) in R1R1 patients who present with anti-E. / Shirey, R. S.; Ness, Paul Michael; Ness, P. M.

In: Transfusion, Vol. 34, No. 9, 1994, p. 756-758.

Research output: Contribution to journalArticle

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abstract = "Background: Because the Rh antigens E (Rh3) and c (Rh4) are relatively immunogenic, it has been suggested that R1R1 (E-, c-) patients who present with anti-E alone receive prophylactic c- (Rh:-4) red cell transfusions. Study Design and Methods: To determine the utility of this approach, the transfusion records of 100 consecutive R1R1 patients with anti-E identified over a 6-year period were reviewed. Results: Thirty-two (32{\%}) had anti-c concurrent with anti-E. Twenty-seven of the 68 patients who presented with anti-E alone received random (i.e., not typed for c [Rh4]) red cell transfusions. Five (18.5{\%}) of the 27 subsequently developed anti-c 13 to 193 days (mean, 50) after transfusion of 2 to 14 (mean, 8) red cell units. None of the five had clinical evidence of hemolysis that could be attributed to a delayed hemolytic transfusion reaction. Twenty-two (81.5{\%}) of the 27 failed to develop anti-c even after transfusion of 1 to 41 (mean, 9; median, 7) red cell units. Conclusion: The overall rate of immunization to c (Rh4) antigen in R1R1 patients with anti-E was 37 percent. Production of anti-c following transfusion to R1R1 patients with anti-E occurred in 18.5 percent of the cases in this series, which could have been avoided by the prophylactic use of R1R1 (E-, c-) blood for transfusion. The prophylactic use of c- (Rh:-4) blood in this patient population may be justified by the high immunization rate and the potential risk of delayed hemolytic transfusion reaction.",
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