Prevalence and specificity of red blood cells alloantibody among patients in hospital Seberang Jaya, Pulau Pinang, Malaysia

Abstract

Alloimmunization is common among transfusion recipients due to the human body defence mechanism as it is exposed to a foreign antigen on the donor's red blood cells. The antibody developed in transfusion recipients varies among the different population. This study determines the prevalence and specificity of red blood cells alloantibody detected during pre-transfusion testing among patients at Hospital Seberang Jaya, Pulau Pinang, Malaysia. A cross-sectional study was carried out among the 17,708 patients admitted and underwent antibody screening test within one year. The study was then narrowed to focusing on the patients that showed positive antibody screen- ing results for further analysis. A total of 226 patients were selected out of the total 17,708 samples with the incidence of 1.28%. The red blood cells al- loantibodies were detected in 179/226 (79.2%) patients, and a combination of auto and alloantibodies were identified in 2/226 (0.9%) patients. There were 44 (19.5%) patients with undetermined antibody specificity. 170 (75.2%) patients had developed a single antibody, while 56 (24.8%) patients had developed multiple antibodies. For single alloantibody, the non-specific antibody was the most identified with 44 (19.5%) patients, followed by anti- D 31 (13.7%) patients, and anti-Lea 26 (11.5%) patients. As for multiple specificity antibody cases, the combination of anti-Lea and anti-Leb were the most common antibodies identified with 33 (14.6%) of the cases. Among the 226 patients, 50 (22.1%) have a history of blood transfusion, while 118 (52.2%) were without blood transfusion, while no information was available for the remaining 58 (25.6%) patients. In view of the alloimmunization cases among patients, antibody screening is a crucial part of pre-transfusion testing in order to provide the most suitable blood and avoid compromising patient's safety.