# Assessment of risks of feline mismatched transfusion and neonatal isoerythrolysis in the Lyon (France) area

Alexandra Nectoux, Maryline Guidetti, Anthony Barthélemy, Céline

Pouzot-Nevoret, Guillaume L Hoareau, Isabelle Goy-Thollot

► To cite this version:

Alexandra Nectoux, Maryline Guidetti, Anthony Barthélemy, Céline Pouzot-Nevoret, Guillaume L Hoareau, et al.. Assessment of risks of feline mismatched transfusion and neonatal isoerythrolysis in the Lyon (France) area. European Veterinary Emergency and Critical Care Congress, Jun 2019, Tallin, Estonia. **hal-05079145**

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<figure><img src="image_1.png" /></figure>

# ASSESSMENT OF RISKS OF FELINE MISMATCHED TRANSFUSION AND NEONATAL ISOERYTHROLYSIS IN THE LYON (FRANCE) AREA.

<figure><img src="image_2.png" /></figure>

Alexandra Nectouxª, Maryline Guidettiᵇ, Anthony Barthélemyª, Céline Pouzot-Nevoretª, Guillaume L Hoareauᶜ, Isabelle Goy-Thollotª

ªIntensive Care Unit (SIAMU), Université de Lyon, VetAgro Sup, APCSe, F-69280, Marcy l'Étoile, France

ᵇDianov Laboratories, F-69760 Limonest, France

ᶜClinical Investigation Facility, David Grant USAF Medical Center, Travis Air Force Base, Fairfield, 94533 CA, USA

## INTRODUCTION

Significant geographical variation of AB feline blood type has been described in the world. Risks of life-threatening acute immune-mediated hemolytic reactions due to mismatched transfusion (MT) and neonatal isoerythrolysis (NI) depend on the proportion of anti-A and anti-B alloantibodies and on the respective prevalence of blood types.

The aims of this study were to update the prevalence of feline blood types in the Lyon (France) area and to determine the risk of MT with untyped donors and recipients and NI in kittens with parents of unknown blood-types.

<figure><img src="image_3.png" /><figcaption>**Figure 1:** Feline blood type results on immunochromatographic strip kit (CHROM Method, Lab Test A+B, Alvedia).</figcaption></figure>

A and B visible band indicated the expression of the antigen on RBCs membranes. The C band represent the positive control.

## MATERIALS AND METHODS

Blood samples were obtained from blood donor cats and from cats admitted to the intensive care unit (SIAMU) of VetAgro Sup in Lyon (France) between January 2011 and January 2017. AB blood typing was performed using an immunochromatographic strip (Figure 1).

Risk of MT was estimated by adding the risk of a major transfusion reaction (MTR) and the risk of a minor transfusion reaction (mTR).¹ MTR is a life-threatening transfusion reaction and was calculated as the percentage of type B cats multiplied by the percentage of non-type B cats.¹ mTR can reduce red blood cells (RBCs) life span and was calculated as the percentage of type B cats multiplied by the percentage of type A cats.¹

Risk of NI was estimated according the equation (p²)(q²) + 2pq(q²) with q being the B allele frequency and p = 1-q.² As those formula do not include type AB cats, our data are not in an equilibrium.

Results were analyzed by absolute and relative frequency analysis and multivariate analysis.

<table><caption>**Table 2:** Prevalence of type A, B, and AB blood type in non-pedigreed cats in several countries. Calculation of risks for MTR, mTR, NI, and NI.</caption><thead><tr><th>City or region</th><th>No. of non-pedigreed cats</th><th>Type A (%)</th><th>Type B (%)</th><th>Type AB (%)</th><th>MTR (%)</th><th>mTR (%)</th><th>MT (%)</th><th>Mating at risk for NI (%)</th></tr></thead><tbody><tr><td>Sydney¹</td><td>187</td><td>62.0</td><td>36.0</td><td>1.6</td><td>22.9</td><td>22.3</td><td>45.3</td><td>23.0</td></tr><tr><td>South east of United Kingdom³</td><td>105</td><td>67.6</td><td>30.5</td><td>1.9</td><td>21.2</td><td>20.6</td><td>41.8</td><td>21.2</td></tr><tr><td>Turkey⁴</td><td>301</td><td>73.1</td><td>24.6</td><td>2.3</td><td>18.5</td><td>18.0</td><td>36.5</td><td>18.5</td></tr><tr><td>Greece⁵</td><td>207</td><td>78.3</td><td>20.3</td><td>1.4</td><td>16.2</td><td>15.9</td><td>32.1</td><td>16.2</td></tr><tr><td>Dublin⁶</td><td>137</td><td>84.7</td><td>14.6</td><td>0.7</td><td>12.5</td><td>12.4</td><td>24.9</td><td>12.5</td></tr><tr><td>Lyon</td><td>320</td><td>83.8</td><td>14.3</td><td>1.9</td><td>12.3</td><td>12.0</td><td>24.3</td><td>12.3</td></tr><tr><td>Beijing⁷</td><td>262</td><td>88.2</td><td>11.4</td><td>0.4</td><td>10.1</td><td>10.1</td><td>20.2</td><td>10.1</td></tr><tr><td>Gran Canaria Island⁸</td><td>97</td><td>88.7</td><td>7.2</td><td>4.0</td><td>6.7</td><td>6.4</td><td>13.1</td><td>6.7</td></tr><tr><td>North Italy⁹</td><td>140</td><td>90.7</td><td>7.1</td><td>2.1</td><td>6.6</td><td>6.4</td><td>13.0</td><td>6.6</td></tr><tr><td>Germany¹⁰</td><td>Not reported</td><td>93.9</td><td>5.4</td><td>0.7</td><td>5.1</td><td>5.1</td><td>10.2</td><td>5.1</td></tr><tr><td>Montreal¹¹</td><td>178</td><td>94.4</td><td>5.0</td><td>0.6</td><td>4.8</td><td>4.7</td><td>9.5</td><td>4.8</td></tr><tr><td>Barcelona¹²</td><td>100</td><td>94.0</td><td>5.0</td><td>1.0</td><td>4.8</td><td>4.7</td><td>9.5</td><td>4.8</td></tr><tr><td>North Portugal¹³</td><td>159</td><td>89.3</td><td>4.4</td><td>6.3</td><td>4.2</td><td>3.9</td><td>8.1</td><td>4.2</td></tr><tr><td>Rio de Janeiro¹⁴</td><td>172</td><td>94.8</td><td>2.9</td><td>2.3</td><td>2.8</td><td>2.7</td><td>5.5</td><td>2.8</td></tr><tr><td>Lisbon¹⁵</td><td>55</td><td>97.5</td><td>2.1</td><td>0.4</td><td>2.1</td><td>2.0</td><td>4.1</td><td>2.1</td></tr><tr><td>Copenhagen¹⁶</td><td>105</td><td>98.1</td><td>1.9</td><td>0.0</td><td>1.9</td><td>1.9</td><td>3.8</td><td>1.9</td></tr><tr><td>USA¹⁷</td><td>3785</td><td>98.1</td><td>1.7</td><td>0.1</td><td>1.7</td><td>1.7</td><td>3.4</td><td>1.7</td></tr><tr><td>Switzerland¹⁸</td><td>1014</td><td>99.6</td><td>0.4</td><td>0.0</td><td>0.4</td><td>0.4</td><td>0.8</td><td>0.4</td></tr><tr><td>Zagreb¹⁹</td><td>30</td><td>96.7</td><td>0.0</td><td>3.3</td><td>0.0</td><td>0.0</td><td>0.0</td><td>0.0</td></tr><tr><td>Hungary²⁰</td><td>73</td><td>100</td><td>0.0</td><td>0.0</td><td>0.0</td><td>0.0</td><td>0.0</td><td>0.0</td></tr></tbody></table>

<table><caption>**Table 1:** Prevalence of type A, B, and AB blood type in non-pedigreed cats and pedigreed cats.</caption><thead><tr><th>Breed</th><th>Total no. of cats</th><th>No. (%) of type A cats</th><th>No. (%) of type B cats</th><th>No. (%) of type AB cats</th></tr></thead><tbody><tr><td>Non-pedigreed</td><td>320</td><td>268 (83.8)</td><td>46 (14.3)</td><td>6 (1.9)</td></tr><tr><td>males</td><td>170</td><td>142 (83.5)</td><td>24 (14.1)</td><td>4 (2.4)</td></tr><tr><td>females</td><td>150</td><td>126 (84.0)</td><td>22 (14.7)</td><td>2 (1.3)</td></tr><tr><td>Pedigreed</td><td>37</td><td>33 (89.2)</td><td>4 (10.8)</td><td>0</td></tr><tr><td>males</td><td>21</td><td>20 (95.2)</td><td>1 (4.8)</td><td>0</td></tr><tr><td>females</td><td>16</td><td>13 (81.3)</td><td>3 (18.7)</td><td>0</td></tr><tr><td>Total</td><td>357</td><td>297 (83.2)</td><td>49 (13.7)</td><td>6 (1.7)</td></tr></tbody></table>

## RESULTS

Our cohort-study population included 320 non-pedigreed cats and 37 pedigreed cats from the Lyon area. Prevalence of blood types A, B, and AB were 83.2%, 13.7%, and 1.7%, respectively. Considering non-pedigreed cats, prevalence of types A, B, and AB were 83.8%, 14.3%, and 1.9%, respectively (Table 1). There were no significant differences in blood type distribution by sex (P = 0.73) or by breed (P = 0.90). Based on these percentages, the calculated risks of MT and NI in non-pedigreed cats were 24.3% and 12.3%, respectively.

## CONCLUSION AND CLINICAL RELEVANCE

Regarding previously published data on prevalence of AB blood type in several countries, risks of MTR, mTR, MT, and mating risk for NI were calculated using the same calculation as in the present study in France (Table 2). The five countries where risks of MT and NI were the most elevated were Australia, England, Turkey, Greece and Ireland. The present study placed France as the sixth riskiest. Prevalence of type B cats was high in France and associated with high risks of MT and NI. Recent research focused on naturally occurring alloantibodies highlighted the existence of alloantibodies against non-AB blood type²¹ so these calculation probably underestimated clinical risk.

These results confirmed the importance of performing blood typing prior to any blood transfusion or mating.

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