Treatment - Red Cell Alloimmunization

Transfusion

All future RBC transfusions should be antigen negative for each clinically significant antibody that the patient has formed.

Depending on the number and type of antibodies, delays in the provision of compatible blood could occur depending on the services and blood supply at the hospital transfusion service. Therefore to the extent possible, RBC transfusions for such patients should be planned in advance. Occasionally it may even be necessary to arrange for the provision of stored frozen autologous or compatible allogeneic RBCs.

Although debate exists about its merits, for selected high-risk patients with transfusion-dependent diseases (e.g., sickle cell anemia, thalassemia, etc) some transfusion services phenotype patients and provide phenotypically matched donor RBC, even to those patients without alloantibodies (i.e., to prevent the formation of antibodies). There is general agreement that this is useful for Rhesus and Kell blood group antigens in these groups of patients, but debate exists about its merits for more extensive phenotyping.

Pregnancy 

All pregnant women with RBC antibodies that may cause haemolytic disease of the foetus/newborn should be referred to an obstetrician experienced in the care of this disorder.

Common red cell (RBC) antibodies that may be associated hemolytic disease of the fetus or newborn (HDFN)*, according to blood group system and antigen specificity

* This list includes only the most common RBC antibodies; it is not exhaustive. For less common antibodies refer to: Issit PD, Anstee DJ. Applied Blood Group Serology, 4th ed. Montgomery Scientific Publications, Durham NC, 1998.