Unexpected Antibody Screening Tests Including Di(a) in Patients with a History of Multiple Packed Red Cell Transfusion

Kim, Moon Jin; Kim, Kyung Hee; Park, Pil Whan; Seo, Yiel Hea; Ahn, Jeong Yeal; Seo, Ja Young; Jeong, Ji Hun; Lee, Hwan Tae

Abstract

BACKGROUND
The Di(a) antigen has been detected with a relatively higher incidence among Koreans with a frequency of 6.4 to 14.5%. In South Korea, commonly used unexpected antibody screening panels do not include Di(a) antigen positive cells. We screened patients who previously received multiple packed red cell transfusion using two cells without Di(a) antigen and three cells including Di(a) antigen to evaluate the effectiveness of three screening cells.
METHODS
A total of 307 patients who had received packed red cell transfusion more than three times during the last 6 months in our hospital were enrolled. They were employed for unexpected antibody screening test using two sets of screening cells not including Di(a) antigen and three sets including Di(a) antigen by LISS/Coombs gel card.
RESULTS
Among 307 patients, 12 were positive using two cells and 15 were positive using three cells. Three patients showed discordant result and one of them was positive for the cell including Di(a) antigen (0.33%). Antibody identification was performed using the panel which does not include Di(a) antigen and it was negative for all of the antigens listed on the panel so that the presence of anti-Di(a) was suspected.
CONCLUSION
It can be difficult to use three cells including Di(a) antigen for all patients due to cost, however, use of three cells is recommended in patients with multiple transfusion history.