The ABO-RhD matched red blood cell transfusion, source of alloantigens occurrence in recipients

Background: The disparity of red blood cell (RBC) antigen between donor and recipient or from mother and fetus involves into red blood cell alloimmunisation. Although anti-D alloimmunization tends to disappear due to the rhesus D (RhD) prophylactic matching coupled with ABO, other antigens including Rh (C, c, E, e) and Kell (K) systems in terms of frequency of occurrence, continue to induce alloimmunization in multitransfused recipients in developing countries. Objectives: The objective of this work is to carry out the different transfusion incompatibilities that may induce alloimmunization especially in multitransfused patients and complicate their subsequent transfusions. Methods: Blood screening in ABO, Rh (D, C, c, E, e) and Kell (K) was performed on opaline plate and confirmed by automatic hematology analyzer on each unit of packed red blood cells and blood sample of the recipient. Results: Different phenotypes were found in both packed red blood cells units and in recipients (p < 0.0001). No incompatibility antigen A, B, and D was identified; as against 89 (28.52%) incompatibilities due to antigens C, E, c, CE and K were found. Conclusion: Our study shows that, in addition to the standard ABO-RhD, systematic phenotyping should be done especially in the mutitransfused recipients’ blood as well as on packed red blood cells transfused to prevent alloantigens occurrence.