Asian Journal of Transfusion Science
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LETTER TO THE EDITOR Table of Contents   
Year : 2020  |  Volume : 14  |  Issue : 1  |  Page : 99-101
Naturally occurring non-ABO alloantibodies in voluntary blood donors


1 Department of Transfusion Medicine and Blood Bank, AIIMS, Raipur, Chhattisgarh, India
2 Department of IHBT, BJMC, Ahmedabad, Gujarat, India

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Date of Submission18-Aug-2019
Date of Acceptance10-May-2020
Date of Web Publication24-Jul-2020
 

How to cite this article:
Lahare S, Gajjar MD, Bhatnagar N, Patel T, Shah M, Wasnik M. Naturally occurring non-ABO alloantibodies in voluntary blood donors. Asian J Transfus Sci 2020;14:99-101

How to cite this URL:
Lahare S, Gajjar MD, Bhatnagar N, Patel T, Shah M, Wasnik M. Naturally occurring non-ABO alloantibodies in voluntary blood donors. Asian J Transfus Sci [serial online] 2020 [cited 2020 Oct 24];14:99-101. Available from: https://www.ajts.org/text.asp?2020/14/1/99/290647




Sir,

Normally, an individual has anti-A and anti-B antibodies present. Pregnancy, transfusion, transplantation, or injections of immunogenic material may cause immunization to red cell antigens. Sometimes, no specific immunizing event can be identified for the production of an antibody against a red cell antigen. Such antibodies are called naturally occurring antibodies.[1],[2]

This study was a descriptive study done prospectively; it was carried out at the red cell serology laboratory of the department of immunohematology and blood transfusion over a period of 6 months from June to December 2014. This study was approved by the institutional ethics committee.

Blood samples collected in pilot tubes (ethylenediaminetetraacetic acid and plain) from 6372 voluntary blood donors (n = 6372) from outdoor blood donation camps who had no history of previous blood transfusion, pregnancy, organ or stem cell transplantation, or transfusion of immunogenic material were subjected to blood grouping and antibody screening in the fully automated immunohematology system “Qwalys-3 (Erythrocytes Magnetized Technology)” [Figure 1].
Figure 1: Flowchart showing protocol followed in this study

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The samples giving a positive result were subjected to manual antibody screening by column agglutination technology in commercially available three-cell antibody screening panel (Bio-Rad) with an autocontrol followed by antibody identification by extended eleven-cell panel if positive reaction on three-cell panel [Figure 2] and [Figure 3].
Figure 2: Three-cell antibody screening panel

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Figure 3: Eleven-cell antibody identification panel

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A total of 19 antibodies were detected with 7 cases of anti-M (male: 6, female: 1), 4 cases of anti-N (male: 4, female: 0), 2 cases of anti-K (male: 2, female: 0), 4 cases of anti-LFA (antibodies against low-frequency antigens) (male: 3, female: 1), 1 case of anti-P1 antibody (male: 1, female: 0), and 1 case of anti-Lea (male: 1, female: 0). Similar findings of naturally occurring such antibodies have been found in several other studies and mentioned in textbooks.[3],[4],[5],[6],[7],[8]

The study had few limitations. Automated immunohematology system detected mainly IgG antibodies, so it was possible that many IgM antibodies might have missed. Antibodies against many low-frequency antigens which were not included in antigram of the automated system might have missed.

To conclude, people without any history of prior red cell immunization can develop alloantibodies which may or may not be clinically significant and can also cause blood grouping discrepancies or incompatible crossmatches. These may also be clinically significant so even in individuals with no prior history of blood transfusion or pregnancy antibody screening, and crossmatching by IAT method is a must. Computer or electronic crossmatches for the samples with a negative antibody screen should be avoided unless an emergency.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Hamilton JR, Bailey DJ. Identification of antibodies to red cell antigens. In: Fung MK, Eder AF, editors. AABB Technical Manual. 19th ed. Bethesda: AABB Press; 2017. p. 349-84.  Back to cited text no. 1
    
2.
LacCE. Naturally Occurring Antibodies vs. Immune Antibodies. Available from: https://www.labce.com/spg1867622_natural ly_occurring_antibodies_vs_immu ne_antibodie.aspx.  Back to cited text no. 2
    
3.
Storry JR. Other protein blood groups. In: Simon TL, McCullough J, editors. Rossi's Principle of Transfusion Medicine. 11th ed. Oxford: Wiley-Blackwell; 2016. p. 185-92.  Back to cited text no. 3
    
4.
Tondon R, Kataria R, Chaudhry R. Anti-M: Report of two cases and review of literature. Asian J Transfus Sci 2008;2:81-3.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Coghlan G. Antibodies to Low incidence antigens. Transfus Apheresis Sci 2009;40:199-202.  Back to cited text no. 5
    
6.
Ito K, Mastuo M. A further example of a probably-naturally-occurring anti kell (Kl) found in Japanese female donor. J Japan Soc Blood Transfus 1980;26:299-300.  Back to cited text no. 6
    
7.
Garg N, Sharma T, Singh B. Prevalence of irregular red blood cell antibodies among healthy blood donors in Delhi population. Transfus Apher Sci 2014;50:415-7.  Back to cited text no. 7
    
8.
Klein HG, Anstee D. Other red cell antigen. In: Mollison's blood Transfusion in Clinical Medicine. 11th ed. Oxford: Blackwell; 2005. p. 209-52.  Back to cited text no. 8
    

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Correspondence Address:
Dr. Saurabh Lahare
HDD 1/222, Phase III, Kabir Nagar, Tatibandh, Raipur, Chhattisgarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajts.AJTS_80_19

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  [Figure 1], [Figure 2], [Figure 3]



 

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