RED BLOOD CELL (RBC) TRANSFUSION FOR PATIENTS HAVING ALLOANTIBODIES AND AUTOANTIBODIES: SELECTION OF APPROPRIATE DONOR BLOOD AND EFFICACY OF ALLOANTIGEN-MATCHED RBCS TRANSFUSION

Autoantibodies against red blood cells (RBC) which react with all cells of a screening panel potentially mask the presence of clinically significant alloantibodies, and interfere with pretransfusion antibody screening and compatibility testing. To remove these autoantibodies, patients' sera were treated using either the ZZAP-or PEG-adsorption methods. Five patients with non-autoimmune hemolytic anemia (non-AIHA) had a single or multiple alloantibodies with the specificities of anti-Dia, anti-E, anti-c+E, anti-c+E+Jkb+Dia, and anti-C+e, respectively. These patients received transfusion of antigen-negative RBCs corresponding to the specificity of the alloantibodies which had been detected in the auto-adsorbed sera after removal of the autoantibodies. The rate (mean, 89%) of hemoglobin increments in all 5 patients was concordant with that (mean, 84%) of the control group. Lactate dehydrogenase levels did not increase significantly after transfusion of compatible RBCs. There findings indicate that autoantibody adsorption procedures are necessary to detect underlying alloantibodies along with autoantibodies. Further transfusion of major alloantigen-matched RBCs is efficient for non-AIHA patients with both allo- and autoantibodies.