Red Cell Alloimmunisation Among Sickle Cell Disease and Thalassemia Patients Following Rh- and K-Matched Red Cell Transfusion in Southwestern Saudi Arabia: A Multicenter Study

Abstract

Abdullah Ahmed Meshi,1,* Hisham Abu-Tawil,2,3 Abdulrahman Ahmed Hamzi,1 Basem Ali Madkhali,4 Ali Bohais Maghfori,1 Ismail Ibrahim Alnami,3 Hassan A Hamali,5 Maymoon Mohammed Madkhali6,* 1Central Blood Bank, King Fahd Central Hospital, Ministry of Health, Jazan, Saudi Arabia; 2Department of Laboratory and Blood Bank, King Faisal Medical City for Southern Regions, Ministry of Health, Abha, Saudi Arabia; 3Department of Laboratory and Blood Bank, Prince Mohammed Bin Nasser Hospital, Ministry of Health, Jazan, Saudi Arabia; 4Department of Laboratory and Blood Bank, Samtah General Hospital, Jazan, Saudi Arabia; 5Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 6Regional laboratory and Central Blood Bank, Ministry of Health, Jazan, Saudi Arabia*These authors contributed equally to this workCorrespondence: Maymoon Mohammed Madkhali, Regional laboratory and Central Blood Bank, Ministry of Health, National Address, GSJRC6587, Jazan, 86715, Saudi Arabia, Email [email protected]: Alloimmunisation remains a major consequence of blood transfusion among sickle cell disease (SCD) and thalassemia patients due to the exposure to non-self-red blood cell (RBC) antigen. The complication is associated with transfusion reactions and delayed transfusion procedure because of the difficulty of finding compatible blood. This study aims to determine the prevalence of alloimmunisation to RBC and alloantibody specificities among SCD and thalassemia patients in, an endemic area of SCD and thalassemia, Jazan province of Saudi Arabia, from three major hospitals.Methods: This is a retrospective, multicenter cross-sectional study conducted on 1027 patients with SCD and thalassemia, which received Rh/K matched transfusions in 2019 in the three centers. Demographic data and medical records of participants from three transfusion institutions were collected and analysed.Results: A total of 1027 were enrolled in the cohort; 906 (88.2%) and 121 (11.8%) patients with SCD and thalassemia, respectively. There were 483 (47%) males and 544 (53%) females with median age of 15 (range 1– 48). Among the studied population, 78 were alloimmunised with an overall alloimmunisation rate of 7.6%. These patients developed a total of 108 alloantibodies, and anti-E was the most detected antibody (25.9%) followed by anti-K (24.1%).Conclusion: The overall rate of alloimmunisation to RBC antigen among the studied population in Jazan was low compared to other areas in the country. Most alloantibodies detected were against E and K antigens. The knowledge of most encountered alloantibodies in our population will aid in selecting the most appropriate antigen-negative red cells. Further research, however, is needed to explore factors associated with residual risk of alloimmunisation in these patients.Keywords: sickle cell disease, thalassemia, red cell transfusion, alloimmunisation, alloantibodies

Keywords

• sickle cell disease
• thalassemia
• red cell transfusion
• alloimmunisation
• alloantibodies