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Results for “BLOOD GROUP INCOMPATIBILITY”

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Transfusion reactions in cats due to AB blood group incompatibility.

Blood transfusion reactions were investigated in 70 unsensitised and sensitised cats. Twenty-five compatible transfusions with respect to the AB blood group system did not result in any immediate transfusion reactions. Transfusion of B erythrocytes in 12 group A cats did not produce any severe reactions because of low anti-B titres in the A recipients. However, 30 of 50 group B cats (60 per cent) suffered severe shock reactions, characterised by marked hypotension, cessation of respiration and sometimes atrio-ventricular blocks, within two minutes of the injection of incompatible A cells (phase 1). From 35 seconds to five minutes later, markedly elevated blood pressures and extrasystoles were recorded (phase 2). The blood pressures generally stabilised within 30 minutes. Haemoconcentration and leucopenia were observed in severely reacting cats and leucopenia was also recorded in some A cats who received incompatible cells but did not exhibit transfusion reactions.

ABO Blood-Group System↗

Prevalence and lack of clinical significance of blood group incompatibility in mothers with blood type A or B.

PURPOSE: To examine the prevalence and clinical significance of blood group incompatibility in infants whose mothers have blood type A or B. METHODS: We prospectively analyzed cord blood samples from 4996 consecutive love-born infants for blood type, hematocrit, and results of direct antiglobulin (Coombs) test (DAT) and indirect Coombs test (ICT). OUTCOME MEASURES: Erythrocyte sensitization was determined by positive DAT or ICT results. Significant hyperbilirubinemia (> or = 224 mumol/L (12.8 mg/dl) and mean cord hematocrits were compared between mother-infant pairs with ABO incompatibility and positive DAT or ICT results and those with negative Coombs test results. RESULTS: Of all births, 6.9% (343/4996) were of infants who had ABO incompatibility and had been born to mothers with blood type B or A; 44 (13%) of 343 infants had a positive antiglobulin test result, of whom 43 had a positive ICT result only. Type A or B mothers were 5.5 times less likely to have sensitization than type O mothers; A-B, B-A, A-AB, and B-AB mother-infant pairs with a positive antiglobulin test result had mean cord hematocrits and rates of significant hyperbilirubinemia similar to those of corresponding pairs whose antiglobulin tests both showed negative results. Infants with a positive DAT result had lower mean cord hematocrits than infants with negative results on both antiglobulin tests or on a positive ICT result only. Significant hyperbilirubinemia was more frequent in infants with a positive DAT result than in infants with negative results on both antiglobulin tests or a positive ICT result only. CONCLUSION: Sensitization is much rare when the mother has blood type A or B than when she has blood type O, as demonstrated by the antiglobulin test. The incidence of significant hyperbilirubinemia and lower cord hematocrit is not increased by sensitization when the mother has type A or B.

ABO Blood-Group System↗

Islet cell autoantibodies in cord blood from children with blood group incompatibility or hyperbilirubinemia.

Blood group incompatibility is a risk factor for type 1 diabetes. Our aim was to test the hypothesis that islet cell autoantibodies, as markers for beta cell autoimmunity, are increased in cord blood from newborns with a diagnosis of blood group incompatibility. Using the diagnosis register of the Malmö University Hospital we obtained cord blood from 151 children with ABO immunization, 311 children with hyperbilirubinemia and a control group of 320 other children born during the same time period. The cord blood samples were analyzed for islet cell antibodies (ICA) by indirect immunofluorescence and autoantibodies against the Islet Cell Antigen-2 (IA-2Ab) and the 65 kDa isoform of glutamic acid decarboxylase (GAD65Ab) by standard radioligand binding assays. The prevalence of ICA was increased compared to controls (0.6%) not only in children with ABO immunization (4.0%, p = 0.02), but also in newborn children with hyperbilirubinemia (4.2%, p = 0.003). The prevalence of IA2Ab, but not of GAD65Ab, was increased in children with ABO immunization (3.3%) compared to the hyperbilirubinemia group without incompatibility (0.6%, p = 0.04), or the controls (0.3%, p = 0.02). Our findings that hyperbilirubinemia is associated with an increased prevalence of ICA, and blood group incompatibility with both ICA and IA-2, suggests that intra-uterine factors may be associated with islet cell autoimmunity.

ABO Blood-Group System↗

Recovery of hematopoiesis after blood-group-incompatible bone marrow transplantation with red-blood-cell-depleted grafts.

Severe hemolytic transfusion reactions may complicate major blood-group-incompatible bone marrow transplantations (BMT). Probably the most appropriate way to avoid this complication is removal of the incompatible red blood cells (RBC) from the bone marrow graft. In this report we describe a method to eliminate incompatible RBCs that is based on repeated dilution of the graft with donor-and-recipient--compatible third-party erythrocytes. Four patients with ABO incompatibility and one patient with Rh-C incompatibility were transplanted using this technique. After the procedure 86 +/- 8% (mean +/- SD) of the nucleated cells, 95 +/- 14% of CFU-GM, 88 +/- 14% of BFU-e, and 103 +/- 30% of CFU-e were recovered, but only +/- 1% of the incompatible RBCs was left in the transfusate (1-3 ml). No signs of hemolysis were observed. All patients engrafted promptly. The patients with low titers of antibody had normal reticulocyte recoveries. Maturation of erythropoiesis was suppressed only when high titers of antibody were present. However, despite high antibody titers, erythroid progenitor cells (CFU-GEMM, BFU-e, and CFU-e) could be cultured from the bone marrow of the recipient after BMT. Thus, anti-A and anti-Rh-C antibodies give little, if any, inhibition of stem-cell proliferation. The method described to remove incompatible RBCs appears to be simple, safe, and--in most cases--sufficient.

Blood Group Antigens↗

Hemotherapy in patients undergoing blood group incompatible bone marrow transplantation.

The management of hemotherapy in 31 cases of ABO- or Rh-incompatible bone marrow transplantation is described. Our experience confirms that ABO or Rh incompatibility does not adversely affect engraftment, patient survival, or incidence of graft-versus-host disease. Eighteen recipients with ABO antibodies against the donors' red cells (major incompatibility) were managed by different combinations of plasma exchange, transfusion of incompatible donor type red cells, and removal of donor-type red cells from the bone marrow before transplant. The only serious complication was delayed hemolysis in seven of nine patients who received incompatible red cell transfusions before transplant. Thirteen patients received bone marrow containing ABO antibodies against their red cells (minor incompatibility). Five were managed by centrifuging the bone marrow to remove plasma and reduce the amount of antibody. This did not cause substantial loss of stem cell activity (60-100% of original marrow), and no patients had complications related to the marrow transfusion. In contrast, two of seven patients who received uncentrifuged bone experienced hemolysis. Two of four Rh positive recipients who received marrow from an Rh negative donor developed anti-D, possibly due to Rh positive blood components transfused after transplantation. None of eight Rh negative patients who received an Rh positive transplant has developed anti-D. Blood components should be selected to avoid transfusion of incompatible red cells and to avoid transfusion of a large amount of incompatible plasma. This may necessitate use of plasma components of a different ABO type than the red cell components.

ABO Blood-Group System↗