Red blood cell antigens and antibodies in patients awaiting renal transplantation

[摘要] Introduction:The importance of blood groups in transfusion therapy and transplant is very well known. The presence of red blood cell antibodies can mediate severe hemolytic transfusion reactions and transplant rejection.Objective : To characterize red blood cell antigens and antibodies in patients awaiting renal transplantation.Methods: A prospective study in 980 patients in waiting list for renal transplantation in the period from July, 2013 to July, 2014 was carried out. The frequency of ABO, Rh (DCcEe), Kell (K), Duffy, Kidd and Lewis blood groups, and the screening of red blood cells auto and alloantibodies by the direct and indirect antiglobulin test (Coombs) and the polietilenglicol technique were investigated.Results : Blood group O was the most frequent followed by A, B and AB. DCCee phenotype was frequent in white individuals and Dccee in non-white. RhD negative (ccee) was more frequent in whites than in non-whites. Distribution of Kell antigen was similar in both groups. Direct antiglobulin test was positive In 14 patients (1,4 %) and red blood cell alloantibodies were identified in 35 patients for a frequency of alloimmunization of 3,6 %. Anti-Rh anti-K antibodies were the alloantibodies most frequently identified. The polietilenglicol technique detected a higher number of antibodies than the indirect antiglobulin test, specially against RhD antigen, although the comparison was not statistically significant.Conclusions: The frequency of alloimmunization is smaller than those communicated in other studies which was related to transfusion records. A periodic red blood cell auto and alloantibodies screening is recommended in all patients awaiting renal transplantation.

[学科分类] 生理学与病理学

[关键词] renal transplantation;red blood cell antibodies;blood groups;Coombs test