bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti-Kpa–induced severe delayed hemolytic transfusion reaction
Authors: Koshy R. , Patel B. , Harrison J.S. 
Published: May 2021

Abstract
Kpa is a low-frequency antigen occurring in less than 2 percent of the Caucasian population. Mild to moderate delayed hemolytic transfusion reactions (DHTR) and hemolytic disease of the fetus and newborn attributable to anti-Kpa have been reported. Severe overt DHTR has not been reported with anti-Kpa. A case of a severe DHTR attributed to anti-Kpa after multiple RBC transfusions is being reported. A 52-year-old Caucasian woman received multiple units of RBCs for a lower gastrointestinal bleed. She was referred to our institution for hepatic and renal failure, which was supported by laboratory findings of peak LDH, bilirubin, BUN, and creatinine elevations. Hemoglobin had dropped on Day 10 after transfusion. The DAT and antibody screen (ABS) were negative. Initial workup and subsequent ABS were negative. Anti-Kpa was identified when an additional RBC panel was tested. One of the RBC units transfused was incompatible by antihuman globulin (AHG) crossmatch with the patient’s plasma and typed positive for Kpa. DHTR was confirmed after extensive workup. The patient responded to supportive therapy and experienced an uneventful recovery. DHTR may not be considered when DAT and ABS are negative. However, correlation of recent transfusion with signs and symptoms should alert the clinician to entertain and investigate a DHTR that should include the AHG crossmatch of all implicated RBC units. The severity of the reaction also raises concerns as to when and what antigen specificity should be considered for inclusion in the antibody screening cells.
Immunohematology

2009;25:44–47.
Southeast Asian ovalocytosis is associated with increased expression of Duffy antigen receptor for chemokines (DARC)
Authors: Woolley I.J. , Hutchinson P. , Reeder J.C. , Kazura J.W. , Cortés A. 
Published: May 2021

Abstract
The Duffy antigen receptor for chemokines (DARC or Fy glycoprotein) carries antigens that are important in blood transfusion and is the main receptor used by Plasmodium vivax to invade reticulocytes. Southeast Asian ovalocytosis (SAO) results from an alteration in RBC membrane protein band 3 and is thought to mitigate susceptibility to falciparum malaria. Expression of some RBC antigens is suppressed by SAO, and we hypothesized that SAO may also reduce Fy expression, potentially leading to reduced susceptibility to vivax malaria. Blood samples were collected from individuals living in the Madang Province of Papua New Guinea. Samples were assayed using a flow cytometry assay for expression of Fy on the surface of RBC and reticulocytes by measuring the attachment of a phycoerythrin-labeled Fy6 antibody. Reticulocytes were detected using thiazole orange. The presence of the SAO mutation was confirmed by PCR. There was a small (approximately 10%) but statistically significant (p=0.049, Mann-Whitney U test) increase in Fy expression on SAO RBC compared with RBC from individuals without this polymorphism: mean Fy expression (mean fluorescence intensity [MFI]) was 10.12 ± 1.22 for SAO heterozygotes versus an MFI of 8.95 ± 1.1 for individuals without SAO. For reticulocytes the MFI values were 27.61 ± 19.12 for SAO heterozygotes and 16.47 ± 3.81 for controls. SAO is associated with increased and not decreased Fy6 expression so that susceptibility to P. vivax infection is unlikely to be affected.
Immunohematology

2009;25:63–66.
Quality activities associated with hospital tissue services
Authors: Hillberry C.M. , Schlueter A.J. 
Published: May 2021

Abstract
Quality assurance is a vital component of a tissue service that aims to meet regulatory requirements and provide safe and functional tissue for surgical procedures in the institution. Many hospital transfusion services have or are in the process of assuming tissue service functions for their institutions, and the concepts of tissue quality assurance requirements should be familiar to the transfusion service. This review discusses the key aspects of tissue service quality assurance, including requirements for FDA registration, selection and qualification of tissue suppliers, recordkeeping, management of occurrences and tissue recalls, adverse event reporting, audits, and quality control. Comparing the similarities and differences between tissue and blood component regulatory requirements suggests transfusion service processes can be readily adapted to incorporate quality assurance for tissue service activities.
Immunohematology

2009;25:102–106.
Recognition and management of antibodies to human platelet antigens in platelet transfusion–refractory patients
Authors: Vassallo R.R. 
Published: May 2021

Abstract
Platelet transfusion refractoriness is a problem for parous and multiply transfused patients, placing them at higher risk for morbidity and mortality when posttransfusion count increments are significantly lower than expected. Although nonimmune causes of transfusion refractoriness are very common, HLA alloantibodies are the most important of the less frequent immune factors responsible for inadequate count increments. As universal leukoreduction decreases the occurrence of HLA antibody formation, antibodies to human platelet antigens (HPAs), an even less common immune factor, may rise proportionately. Carefully matched apheresis platelets can substantially improve platelet count increments in the setting of HLA and HPA alloantibody-mediated transfusion refractoriness. An evidence-based HPA testing strategy is described along with the incidence and specificity of HPA antibodies in platelet transfusion refractoriness. Optimal strategies to manage patients with HPA or combined HPA and HLA antibodies are presented. Ultimately, close cooperation between ordering physicians and the blood provider is critical in choosing the correct tests and assuring platelet availability during intensive support of these challenging patients.
Immunohematology

2009;25:119–124.
Hyperhemolytic transfusion reaction attributable to anti-Fy3 in a patient with sickle cell disease
Authors: Reyes M.A. , Illoh O.C. 
Published: May 2021

Abstract
A case of hyperhemolytic transfusion reaction attributable to anti-Fy3 in a 30-year-old African American woman with a history of sickle cell disease is reported. The patient was admitted for vaso-occlusive sickle cell crisis and received 4 units of packed RBCs secondary to worsening symptomatic anemia (Hb 5.0 g/dL). On admission, the patient’s antibody screen and identification showed anti-V and anti-E, and her antibody history included anti-E, -C, -Jkb, -N, -V, -S, -Sla, and a cold agglutinin with possible anti-I specificity. A DAT performed on her RBCs was negative. RBC units that lacked E,C,Jkb,N,V,and S were transfused. Posttransfusion Hb was 8.9 g/dL. On day 10 she developed a fever of 103°F, and on day 11 her Hb decreased to 6.4 g/dL. She complained of severe back pain and dark urine. In addition, she became hypertensive, tachycardic, and jaundiced. The DAT indicated the presence of IgG on the patient’s RBCs. Anti-Fy3 was identified in the serum and eluate. During the next 24 hours,her Hb decreased to 2.4 g/dL. The LDH level was 1687 U/L, and her reticulocyte count was 2.6%. A delayed hemolytic transfusion reaction with hyperhemolysis secondary to anti-Fy3 was suspected and was successfully treated with IVIG and high-dose prednisone. To the best of our knowledge, this is the first published case of hyperhemolysis in sickle cell disease attributable to anti-Fy3.
Immunohematology

2008:24:45–51.
Transfusion service disaster planning
Authors: Bundy K.L. , Foss M.L. , Stubbs J.R. 
Published: May 2021

Abstract
The Mayo Clinic, in Rochester, Minnesota, recently set forth a directive to develop a Mayo Emergency Incident Command System (MEICS) plan to respond to major disasters. The MEICS plan that was developed interfaces with national response plans to ensure effective communication and coordination between our institution and local, state, and federal agencies to establish a common language and communication structure. The MEICS plan addresses multiple aspects of dealing with resource needs during a crisis, including the need for blood and transfusion medicine services. The MEICS plan was developed to supplement our current local emergency preparedness procedures and provide a mechanism for responding to the escalating severity of an emergency to deal with situations of a magnitude that is outside the normal experience. A plan was developed to interface the existing Transfusion Medicine disaster plan standard operating procedures (SOP) with the institutional and Department of Laboratory Medicine (DLMP) MEICS plans. The first step in developing this interface was defining MEICS. Other major steps were defining the chain of command, developing a method for visually indicating who is “in charge,” planning communication, defining the actions to be taken, assessing resource needs, developing flowcharts and updating SOPs, and developing a blood rationing team to deal with anticipated blood shortages. Several key features of the interface and updated disaster plan that were developed are calling trees for response personnel, plans for relocating leadership to alternative command centers, and action sheets to assist with resource assessment. The action sheets also provide documentation of key actions by response personnel.
Immunohematology

2008;24:93–101.
Molecular analyses of GYPB in African Brazilians
Authors: Omoto R. , Reid M.E. , Castilho L. 
Published: May 2021

Abstract
The molecular background of variant forms of GYPB is not well studied in Brazilians of African descent. The present study was carried out to determine the molecular bases of the S–s– phenotype and the frequency of GYPB*S silent gene for the S–s+ phenotype in a blood donor population of African Brazilians. In this study, 165 blood samples from African Brazilians (Northeastern Brazil) who phenotyped as S–s– (n = 17) and S–s+ (n = 148) by hemagglutination were selected. Allele-specific (AS)-PCR and PCR-restriction fragment length polymorphism (RFLP) were used to identify the variant forms of GYPB. In 13 of 17 S–s– samples (76.5%), both GYPB were deleted. In 137 of the 148 S–s+ samples (92.6%), the AS-PCR was consistent with the S–s+ phenotype. In 4 of the S–s– samples (23.5%) and 11 of the S–s+ samples (7.4%), the AS-PCR showed the presence of a GYPB*S allele associated with silencing of S. In the 4 donors with the S–s– phenotype, there was homozygosity (or hemizygosity) for the GYP(P2) allele (n = 2), homozygosity (or hemizygosity) for the GYP(NY) allele (n = 1), and heterozygosity for the GYP(P2) and GYP(NY) alleles (n = 1). In the 11 donors with the S–s+ phenotype, there was heterozygosity for GYP(P2) allele (n = 8) and heterozygosity for GYP(NY) allele (n = 3). This study reports for the first time the molecular mechanisms responsible for the S–s– phenotype in a population of African Brazilians and provides new information about the frequency and molecular bases of the GYPB*S silent gene (7.4%) in this population.
Immunohematology

2008;24:148-153.
Application of gel technology in the serologic characterization of autoantibody in DAT-positive autoimmune diseases
Authors: Das S.S. , Chaudhary R.K 
Published: May 2021

Abstract
Gel tests are now available for the determination of immunoglobulin classes and subclasses and complement fractions coating RBCs. These tests simplified serologic characterization of autoantibodies in various autoimmune diseases. The aim of this study was to evaluate the use of gel cards in the serologic characterization of autoantibody with regard to the immunoglobulin classes, complement fractions, and IgG subclasses, and the influence of these characteristics on hemolysis. Gel cards were used to characterize the RBC-bound autoantibodies in 66 DAT-positive patients. Hematologic and biochemical parameters such as Hb, reticulocyte count, serum bilirubin, and serum LDH were obtained from the patient files. Of the 49 patients carrying IgG on their RBCs, 21 (42.8%) were suffering from connective tissue disorders and another 16 patients (32.7%) had autoimmune hemolytic anemia. A total of 19 of these 49 patients had evidence of hemolysis. Thirteen of the 17 patients (76.5%) whose RBCs were coated with more than one type of immunoglobulin and complement were experiencing hemolysis (p < 0.05). Seventy-five percent (21 of 28) of patients having IgG1, IgG3, or both on their RBCs showed hemolysis (p < 0.05). Thus, it is important to serologically characterize autoantibodies in autoimmune disorders to effectively predict the prognosis and disease outcome. This characterization can be performed effectively with the gel test, which can be introduced in blood centers as a replacement to the conventional tube technique.
Immunohematology

2007; 23:59–62.
Consortium for Blood Group Genes (CBGG): 2007 report
Authors: Reid M.E , Westhoff C. , Denomme G. , Castilho L. 
Published: May 2021

Abstract
The Consortium for Blood Group Genes is a worldwide organization whose goal is to have a vehicle to interact, establish guidelines, operate a proficiency program, and provide education for laboratories involved in DNA and RNA testing for the prediction of blood group, platelet, and neutrophil antigens.
Immunohematology

2007;23:165–8.
External quality assessment scheme in red blood cell serology: a 5-year experience in Thailand
Authors: Bejrachandra S. , Saipin J. , Nathalang O. , Siriboonrit U. , Rungroung E. , Udee S. 
Published: May 2021

Abstract
From 2000 to 2004, 36, 58, 72, 78, and 86 laboratories participated in an external quality assessment scheme (EQAS) organized by the Department of Transfusion Medicine, Faculty of Medicine Siriraj Hospital. Each year the staff was requested to perform ABO grouping, D typing, antibody screening, antibody identification, and DATs on eight blood samples. Each participant received information on the correct test results and a coded summary. Regarding ABO grouping, the error rate ranged from 0.3 to 1.3 percent, mostly due to human errors. Error rates in D typing ranged from 0.7 to 5.7 percent, the most problematic being weak D phenotype interpretation. Although every sample was negative by the DAT, error rates due to false positive test results were determined to be 0.4 to 2.1 percent. Antibody screening errors were also found; however, errors steadily decreased from 4.2 percent in 2000 to 0.3 percent in 2004. Only 69.4 to 87.2 percent of laboratories performed antibody identification; however, correct results increased from 78.4 to 91.0 percent. In conclusion, an EQAS in RBC serology should be used to compare results from different laboratories and to identify those laboratories that need improvement in testing procedures.
Immunohematology

2006;22:1–5.
Reduced red blood cell destruction by antibody fragments
Authors: Mqadmi A. , Abramowitz S. , Zheng X. , Yazdanbakhsh K. 
Published: May 2021

Abstract
Antibodies to blood group antigens can cause immune RBC destruction directly (extravascular destruction) or indirectly through subsequent complement activation (intravascular hemolysis). The Fc portion of the IgG antibody is responsible for the effector functions of immune RBC destruction. We hypothesized that sensitization of RBCs with blood group antigen–specific IgG antibodies lacking their Fc portion would escape from the recipient’s immune system, allowing for a longer survival period of the RBCs in the circulation. Direct injection of mouse RBC-specific Ter-119 monoclonal antibody into mice resulted in a more severe anemia compared with that in mice injected with the Ter-119 F(ab′)2 fragment. We found that mouse RBCs coated in vitro with the Ter-119 F(ab′)2 fragment, when transfused into mice, survived longer in circulation compared with RBCs coated with whole Ter-119 IgG molecule. The data support the conclusion that antibodies can be rendered less pathogenic through removal of their Fc portion.
Immunohematology

2006;22:11–14.
H-deficient Bombay and para-Bombay red blood cells are most strongly agglutinated by the galactophilic lectins of Aplysia and Pseudomonas aeruginosa that detect I and P1 antigens
Authors: Gilboa-Garber N. , Sudakevitz D. , Levene C. , Rahimi-Levene N. , Yahalom V. 
Published: May 2021

Abstract
The galactophilic lectins Aplysia gonad lectin (AGL) and Pseudomonas aeruginosa lectin (PA-IL), which detect human I and P1 RBC antigens, were examined for hemagglutination of H+ (group O and B) and H-deficient (Bombay and para-Bombay phenotype) RBCs. The results were compared with those obtained using two other galactophilic lectins, Maclura pomifera lectin (MPL) and Arachis hypogaea (peanut) agglutinin (PNA), which share T-antigen affinity, and two fucose-binding H-specific lectins, Ulex europaeus (UEA-I) and Pseudomonas aeruginosa lectin (PA-IIL), as well as with those achieved with anti-I serum. The results revealed that, in contrast to UEA-I and PA-IIL, which preferentially agglutinated H+ RBCs, and to MPL and PNA, which similarly agglutinated all examined RBCs, AGL, PA-IL, and the anti-I serum agglutinated the H-deficient RBCs more strongly than did the H+ RBCs. These findings could be attributed to increased levels of I and P1 antigens on those RBCs resulting from the use of the free common H-type 2 precursor for their synthesis. Since both PA-IL and PA-IIL are regarded as potential pathogen adhesins, it would be interesting to statistically compare the sensitivities of individuals of H+ and H-deficient RBC populations to P. aeruginosa infections.
Immunohematology

2006;22:15–22.
Problems highlighted when using anticoagulated samples in the standard tube low ionic strength antiglobulin test
Authors: Sweeney A.J. 
Published: May 2021

Abstract
Within the UK blood transfusion services, there is currently no recommendation for the use of either clotted or anticoagulated samples for antibody identification testing. This report describes three cases in which the detection of IgM antibodies was impeded by the use of anticoagulated samples. Two patient samples, referred for compatibility testing, were both identified as having IgM complement-activating anti-S and the remaining case involved an antenatal patient with IgM complement-activating anti-Vel. In all three cases, the coincidental referral and investigation of both clotted and anticoagulated samples led to the discrepancy in serum and plasma test results becoming apparent. Potential errors in selection of suitable blood for transfusion and appropriate antenatal management were avoided by correct identification of the antibodies present using the clotted samples.
Immunohematology

2006;22:72–77.
The Charles Drew Program in Missouri: a description of a partnership among a blood center and several hospitals to address the care of patients with sickle cell disease
Authors: Isaak E.J. , LeChien B. , Lindsey T. , DeBaun M.R. 
Published: May 2021

Abstract
Sickle cell disease (SCD) is an inherited blood disorder which can be complicated by stroke in infancy and childhood. The primary and secondary prevention of stroke in this patient population is regular RBC transfusion therapy at least every three weeks, but there is no consensus on the ideal RBC transfusion therapy. The Charles Drew Program, a partnership among a blood center and several hospitals affiliated with academic medical centers in Missouri, provides RBCs for the care of patients with SCD. There are three basic aims: the RBC components are phenotypically matched on three minor RBC antigens, the units are less than 7 days old, and each patient has a limited number of dedicated donors, so that the donor exposure is minimized. This report describes the operational phases of this program and summarizes its performance with respect to each of these aims.
Immunohematology

2006;22:112–116.
Case report: moderate hemolytic disease of the newborn due to anti-G
Authors: Huber A.R. , Leonard G.T , Driggers R.W , Learn S.B. , Gilstad C.W 
Published: May 2021

Abstract
Views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or U.S. Government.
The only previously published case of anti-G in a pregnant woman indicated that anti-G alone caused little, if any, fetal or neonatal hemolysis. This report describes an affected fetus with amnionitic fluid OD 450 absorbance values in the moderate zone of the Liley prediction graph who required prolonged phototherapy after birth until day of life 20. Anti-G was identified and anti-C and -D excluded in the mother’s serum. In contrast to the previous report, this report shows anti-G alone can cause moderate HDN and that fetal monitoring and treatment may be necessary.
Immunohematology

2006;22:166–170.
Expression of Duffy antigen receptor for chemokines during reticulocyte maturation: using a CD71 flow cytometric technique to identify reticulocytes
Authors: Woolley I.J , Wood E.M , Sramkoski R.M. , Zimmerman P.A. , Miller J.P , Kazura J.W 
Published: May 2021

Abstract
Flow cytometric methods commonly used to identify reticulocytes are of limited usefulness in malarious areas, since RNA staining also detects plasmodia. An important antigen expressed on reticulocytes is Duffy antigen receptor for chemokines (DARC, also known as Fy), the receptor for Plasmodium vivax. An early marker for reticulocytes is CD71 (transferrin receptor). We have been interested in CD71 as an alternative marker for reticulocytes in the context of Fy expression. Flow cytometry was used to determine the expression of Fy on CD71-positive and -negative reticulocytes and to correlate serology and genotype. A reduction of 13 percent was seen in Fy6 expression between CD71-positive reticulocytes and RNA-positive reticulocytes. CD71 disappears early during reticulocyte maturation, while Fy6 expression is relatively preserved. CD71 is an alternative to staining for RNA for reticulocyte assays relating to Fy6 expression.
Immunohematology

2005;21:15–20.
The incidence of red cell alloantibodies underlying panreactive warm autoantibodies
Authors: Maley M. , Bruce D.G , Babb R.G. , Wells A.W , Williams M. 
Published: May 2021

Abstract
A recognized hazard of administering blood transfusions to patients with panreactive warm autoantibodies is that alloantibodies may be masked. Studies have shown the incidence of underlying alloantibodies to be 30 to 40 percent. Adsorption procedures can be used to remove autoantibodies and allow detection and identification of underlying alloantibodies. This study contains data from 126 patients referred to the Red Cell Immunohaematology laboratory at the National Blood Service, Newcastle upon Tyne, United Kingdom. These patients were from the northeast of England, a population for which data have not previously been reported. Samples identified as containing panreactive warm autoantibodies were subjected to adsorption procedures (95 by alloadsorption and 31 by autoadsorption). Absorbed sera were then tested to identify underlying alloantibodies. Of 126 samples, 39 (31%) contained a total of 61 RBC alloantibodies; 15 (12%) contained 2 or more antibody specificities; and 14 (11%) contained alloantibodies not found within the Rh or Kell blood group systems. Antibodies identified included the following specificities: E (19), D (9), c (7), C (6), S (5), Fya (3), Jka (2), Jkb (2), K (2), Kpa (2), Fyb, Cw, N, and f (ce). This study reinforces the value of adsorption studies, whether using autologous or allogeneic RBCs, when panreactive warm autoantibodies are present. In addition, this study confirms that it is not appropriate in these cases simply to issue blood which is “least incompatible” or Rh phenotype- and K antigen-matched.
Immunohematology

2005;21:122–125.