A case for a national registry of red blood cell antibodies

• Published in: Vox sanguinis 2022-05, Vol.117 (5), p.738-740
• Main Authors: Mathur, Gagan, Wilkinson, Matthew B., Island, Eddie R., Menitove, Jay E., Tilzer, Lowell
• Format: Article
• Language: English
• Subjects: Antibodies; Antigens; Blood; blood safety; Erythrocytes; Hospitals; Liver transplantation; Morbidity; Patients; RBC antigens and antibodies; serological testing; Transfusion; transfusion reactions; Transplantation
• ISSN: 0042-9007; 1423-0410
• DOI: 10.1111/vox.13250

Background and Objectives Red blood cell (RBC) antibody levels diminish over time and negative antibody screen are commonly seen in patients with a history of antibodies. Most hospitals do not have access to a shared registry of antibodies previously detected at other hospitals. Materials and Methods We describe a case where the patient was found to be at high risk of bleeding during liver transplantation. Antibody screen on admission was negative but a history of anti‐Jka was identified on reviewing patient's history in local registry of RBC antibodies. The surgery was pushed back to arrange for antigen‐negative units. The patient received a total of 16 Jk(a−) RBC units during the admission. Results No acute or delayed transfusion adverse reactions were seen. However, if the history of anti‐Jka identified at another local hospital was not known, approximately three‐quarters of the units transfused would have been Jk(a+). Transfusing Jk(a+) units could have potentially exposed the patient to risk of developing an acute and/or delayed haemolytic transfusion reaction which could have led to significant morbidity and perhaps mortality. Conclusion With this case report, we build a case for developing a national registry of RBC antibodies to help improve patient safety and outcomes.