Alloimmunization following antigen‐negative red blood cell transfusion

• DOI: 10.1111/trf.17208
• Publication Date: 2022-12-02T08:26:46Z
• Authors: Jeremy W. Jacobs; Thomas C. Binns; Elizabeth Abels; Krishna Iyer; Cristina A. Figue...; Anuj Verma; Nataliya Sostin; Christopher A. To...
• Keywords: Isoantibodies; Blood group antigens; Red Cell

Red blood cell (RBC) alloimmunization can occur secondary to transfusion or pregnancy. It is observed most frequently among patients with hemoglobinopathies and myeloid neoplasms. Although previous antigen exposure generally required for alloimmunization, some alloantibodies may develop naturally without prior exposure. Other become evanescent, only reemerge at a detectable titer following stimulatory event. In minute fraction of cases, 'non-naturally occurring' appear known antigenic stimulus.All testing (antibody detection tests identification, phenotyping, crossmatching) was performed using the same method reagents, but occurred two hospitals within Yale New Haven Hospital delivery network, by technologists utilizing different instruments reagent lots.We present cases seemingly de novo (anti-E anti-K), one case re-emergence known, previously evanescent alloantibody (anti-K) RBCs that were antigen-negative corresponding antibodies.While exact mechanism underlying development and/or RBC in absence stimulation remains unclear, these highlight this unusual phenomenon, underscoring general immunogenicity, as well potential consequences, reiterates importance concluding an specificity, even particular antigen.