Optimization of blood safety through essential characterization of naturally occurring lewis antibody

Abstract

Background: Lewis (Le) antibodies are usually naturally occurring; however, they may be clinically significant, may be immunoglobulin G (IgG) type, and may cause hemolytic transfusion reactions. The present study depicts the clinical significance and detailed characterization of Le antibodies in blood donors and patient populations and their implication in safe blood transfusion. Materials and Methods: The prospective study included seven individuals who were detected with Le antibodies. Further investigations were performed for detailed characterization of these antibodies with regard to antibody type, thermal amplitude, titer, and enzyme study and secretor status of the individuals. Results: Of the 69,354 donors and patients subjected to antibody screening, anti-Lea was detected in 7 individuals with none having anti-Leb. All showed the Le (a−b−) phenotype with 4 individuals presenting with IgG anti-Lea optimally reacting at 37°C, with a highest titer of 32. Where all seven individuals were ABH secretors, however none revealed any Le substances. For patients requiring transfusion, compatible Lea antigen-negative red cell units were issued without any adverse events. Conclusions: As naturally occurring Le antibodies may be clinically significant and cause hemolytic transfusion reaction, therefore identification and detailed characterization of antibody in blood donor or recipient is very crucial to blood safety.

Keywords

• Antibody identification
• Lewis antibody
• Lewis antigen
• Lewis system
• thermal amplitude