Aseem Kumar Tiwari1, Dinesh Arora1, Geet Aggarwal1, Ravi C Dara2, Gunjan Bhardwaj1, Jyoti Sharma1, Vijay Vohra3, Arvinder Singh Soin4. 1. Department of Transfusion Medicine, Medanta-The Medicity, Gurugram, Haryana, India. 2. Department of Transfusion Medicine, Manipal Hospital, Jaipur, Rajasthan, India. 3. Department of Liver Transplant Anesthesia, Medanta-The Medicity, Gurugram, Haryana, India. 4. Department of Institute of Liver Transplantation & Regenerative Medicine, Medanta-The Medicity, Gurugram, Haryana, India.
Abstract
BACKGROUND & OBJECTIVES: The number of blood components required during a liver-transplant surgery is significant. It is challenging for blood transfusion services to provide the required RhD-negative red blood cells (RBCs) for recipients during the peri-operative period. This retrospective study presents safety data of transfusing RhD-positive RBCs in RhD-negative living donor liver-transplant (LDLT) recipients during the peri-operative period with six-month follow up for risk of developing alloantibodies. METHODS: All RhD-negative patients who underwent LDLT and were transfused ABO-compatible but RhD-positive RBC units between January 2012 and May 2018 were included in the study. Twenty one RhD-negative patients who received a total of 167 RhD-positive RBCs peri-operatively were chosen for alloantibody screening. All the patients were started on triple immunosuppression drugs as per the standard hospital protocol. Blood grouping, cross-match and antibody screening were done by column agglutination technique. RESULTS: Post-transplant antibody screen (weekly for 12 wk) was negative, and none of the patients developed anti-D alloantibodies till their last follow up (mean 21 months). INTERPRETATION & CONCLUSIONS: Our observations suggest that it may be safe to use RhD-positive RBCs peri-operatively in RhD-negative LDLT recipients with low risk of alloimmunization.
BACKGROUND & OBJECTIVES: The number of blood components required during a liver-transplant surgery is significant. It is challenging for blood transfusion services to provide the required RhD-negative red blood cells (RBCs) for recipients during the peri-operative period. This retrospective study presents safety data of transfusing RhD-positive RBCs in RhD-negative living donor liver-transplant (LDLT) recipients during the peri-operative period with six-month follow up for risk of developing alloantibodies. METHODS: All RhD-negative patients who underwent LDLT and were transfused ABO-compatible but RhD-positive RBC units between January 2012 and May 2018 were included in the study. Twenty one RhD-negative patients who received a total of 167 RhD-positive RBCs peri-operatively were chosen for alloantibody screening. All the patients were started on triple immunosuppression drugs as per the standard hospital protocol. Blood grouping, cross-match and antibody screening were done by column agglutination technique. RESULTS: Post-transplant antibody screen (weekly for 12 wk) was negative, and none of the patients developed anti-D alloantibodies till their last follow up (mean 21 months). INTERPRETATION & CONCLUSIONS: Our observations suggest that it may be safe to use RhD-positive RBCs peri-operatively in RhD-negative LDLT recipients with low risk of alloimmunization.
Entities:
Keywords:
Alloantibody; RhD-negative; living donor liver transplants; red blood cell; transfusion
Authors: N Burin des Roziers; C Ibanez; D Samuel; C Francoz; S Idri; A François; R Mortelecque; P Bierling; F Pirenne Journal: Vox Sang Date: 2016-02-25 Impact factor: 2.144