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Research Article
Red blood cell alloimmunization in multitransfused hemodialysis renal patients in central Sudan
1 Division of Immunology and Pharmaceutical Biotechnology, Department of Pharmaceutics, Faculty of Pharmacy, Jazan University, Saudi Arabia
2 Department of Pathology, Faculty of Medicine, University of Gezira, Wad Medani, Sudan
3 Laboratories Directorate, Khartoum State Ministry of Health, Sudan
4 Faculty of Medical Laboratory Sciences, University of Gadarif, Sudan
5 Faculty of Medical Laboratory Sciences, University of Gezira, Sudan
6 Blue Nile National Institute for Communicable Diseases, University of Gezira, Wad Medani, Sudan
Address correspondence to:
Mohamed Eltaib Elmobark
Department of Pharmaceutics, Faculty of Pharmacy, Jazan University,
Saudi Arabia
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Article ID: 100048Z02ME2019
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Elmobark ME, Abbass AA, Anwer E, Elsharief UA, Nour BYM. Red blood cell alloimmunization in multitransfused hemodialysis renal patients in central Sudan. Int J Blood Transfus Immunohematol 2019;9:100048Z02ME2019.ABSTRACT
Aims: Blood transfusion is an integral part in the management of chronic renal failure (CRF). Alloimmunization is a recognized complication of red blood cell (RBC) transfusion with consequences including delayed hemolytic transfusion reactions and difficulties in getting compatible blood for future transfusion. Therefore, the current study was designed to identify the frequency of RBC alloimmunization and the specificity of alloantibodies against red cell antigen among the hemodialysis patients.
Methods: A total of 301 patients (239 males and 62 females) with CRF who received more than two units of blood and matched for ABO & Rh(D) antigen were enrolled in this cross-sectional study which was carried out from December 2016 to December 2017. After detailed history through questionnaire conducted to the patients, antibody screening was done by 2-cell panel with homozygous expression of the antigens (ID-Diacell I-II-DiaMed). Positive samples were further subjected to antibody identification using commercial panels of 11 cells (ID-DiaPanel- DiaMed).
Results: Out of 301 patients 239 (79.4%) were males and 62 (20.6%) were females. The prevalence of alloimmunization was 16.9% and the most alloantibody frequent was anti-C (21.3%), anti-E (16.4%), and anti-K (14.8%). The most common alloantibodies produced were against Rh system (64%). Dual and triple antibody was observed. All alloantibodies were immunoglobulin G (IgG) class except anti-M was IgG and immunoglobulin M (IgM).
Conclusion: This study showed that 16.9% of the multitransfused patients with chronic kidney disease (CKD) developed alloantibodies, most of which were of the Rh phenotype. These alloantibodies may lead to allograft rejection, or even poor patient survival. Thus, we advocate that renal transplant be instituted at the earliest opportunity whenever it becomes inevitable as a modality of treatment to enhance better outcomes.
Keywords: Alloimmunization, Anemia, Blood transfusion, Chronic kidney failure
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Acknowledgments
Authors are grateful to the staff of the College of Graduate Studies, University of Gezira, Sudanese Society of Renal Transplants and the Institute of Endemic Diseases, University of Khartoum, for their technical assistance and valuable help and guidance. We are also indebted to the Central Blood Bank in Khartoum in Sudan for their support.
Author ContributionsMohamed Eltaib Elmobark - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Asaad Adam Abbass - Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Eman Anwer - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Usama Abdalla Elsharief - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Bakri Yousif Mohamed Nour - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Mohamed Eltaib Elmobark et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
