Red Blood Cell Alloimmunization after Blood Transfusion (LUP Dissertations)

177 Pages·2007·0.92 MB·English

by  H. Schonewille

Current pre-transfusion H
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patients’ serum to be tested for the presence of irregular red n
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blood cell antibodies. In case of an alloantibody, red blood
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cells lacking the corresponding antigen are transfused after an c
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antiglobulin crossmatch. o Henk Schonewille
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The aim of the studies in this thesis is primarily to inves- e
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tigate whether this policy should change to improve transfu-
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sion safety. l
e Red blood cell

This thesis explores the risk on red blood cell alloimmu- ·

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and in patients who already formed antibodies after a previ- b alloimmunization after
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transfusion testing with regard to antibodies to low incidence o
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antigens, timing of antibody testing and antibody persistence c
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Henk Schonewille works as a scientist at the department of o
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Research and Development of Sanquin Blood Bank South- m
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west Region.
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In 2006 Leiden University has initiated a series Leiden Disserta- z
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tions at Leiden University Press. This series affords an opportunity t
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to those who have recently obtained their doctorate to publish n

the results of their doctoral research so as to ensure a wide a
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distribution among colleagues and the interested public. The e
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dissertations will become available both in printed and in digital
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versions. Books from this LUP series can be ordered through lo
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www.lup.nl. The large majority of Leiden dissertations from 2005 d

onwards is available digitally on www.dissertation.leidenuniv.nl. t
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lup dissertations
9 789087 280314
leiden university press
LUP
Schonewille.indd 1 25-11-2007 13:18:19
RED BLOOD CELL ALLOIMMUNIZATION

AFTER BLOOD TRANSFUSION
The publication of this book is made possible by a grant from:
Sanquin Blood Bank South West Region

Cover design: Maedium, Utrecht

ISBN 978 90 8728 031 4
NUR 870

© Leiden University Press, 2008

All rights reserved. Without limiting the rights under copyright reserved
above, no part of this book may be reproduced, stored in or introduced
into a retrieval system, or transmitted, in any form or by any means
(electronic, mechanical, photocopying, recording or otherwise) without
the written permission of both the copyright owner and the author of the
book.
RED BLOOD CELL ALLOIMMUNIZATION

AFTER BLOOD TRANSFUSION

PROEFSCHRIFT

ter verkrijging van
de graad van Doctor aan de Universiteit Leiden,
op gezag van Rector Magnificus prof.mr. P.F. van der Heijden,
volgens besluit van het College voor Promoties
te verdedigen op woensdag 16 januari 2008
klokke 15:00 uur

door

Henk Schonewille

geboren te Vlijmen
in 1959
Promotiecommissie

Promotor: Prof. Dr. A. Brand

Referenten: Prof. Dr. G. Garratty
American Red Cross Blood Services, USA
Prof. Dr. D.J. van Rhenen
Erasmus Medisch Centrum, Rotterdam

Overige leden: Prof. Dr. H.H.H. Kanhai
Dr. P.W. Wijermans
Haga Ziekenhuis, Den Haag
Aan mijn ouders

Voor mijn liefsten: Nel,
en onze jongens
Henk, Willem, Robert & Jeroen

Contents

Chapter 1. General Introduction 9
1.1 Introduction 11
1.2 Outline of the thesis 12

Chapter 2. Review of the literature on red cell
alloimmunization 17
2.1. History of red cell alloimmunization 19
2.2. Red cell compatibility testing 19
2.3. Blood group diversity and function 21
2.4. Immunogenicity 22
2.5. Alloimmune response to red blood cell antigens 24
2.6. Red blood cell antibodies in disease 27

Chapter 3. Alloimmunization to red blood cell antigens after
universal leucodepletion. A regional multicenter
retrospective study 43
(Br. J. Haematol. 2005;129:151-156)

Chapter 4. The importance of antibodies against low-incidence RBC
antigens in complete and abbreviated cross-matching 55
(Transfusion 2003:43;939-944)

Chapter 5. Alloimmunization after blood transfusion in patients
with hematologic and oncologic diseases 69
(Transfusion 1999;39:763-771)

Chapter 6. Additional RBC alloantibodies after blood transfusions
in a nonhematological alloimmunized patient cohort: is it
time to take precautionary measures? 87
(Transfusion 2006;46:630-635)

Chapter 7. High additional maternal red cell alloimmunization
after RH- and K-matched intrauterine intravascular
transfusions for hemolytic disease of the fetus 101
(Am. J. Obstet. Gynecol. 2007;196:143.e1-e6)

7
Chapter 8. RBC antibody persistence 115
(Transfusion 2000;40:1127-1131)

Chapter 9. Red blood cell alloantibodies after transfusion:
factors influencing incidence and specificity 127
(Transfusion 2006;46:250-256)

Chapter 10. General discussion 143

Summary 153
Samenvatting 163
Curriculum Vitae 173
Publications 174
8
1

GENERAL INTRODUCTION