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P101 Coincidental occurrence of RBC and HLA class I antibodies in renal transplant patients
Posters, ISH EAD 2007, Budapest, Hungary, 29 August Results: Platelet antibodies were detected in 6 of the 15 maternal serums. The specificity of the antibodies were anti-HPA-1a (n = 3), HPA-5b (n = 3), anti-HLA (n = 3), and antiHLA+panreactive HPA (n = 3). The cross-matches with paternal platelets were positive in these cases. Antibodies were not detected in 9 of 15 maternal blood samples, and paternal crossmatches were negative as well. Four new maternal serums of the initial negative cases were retested 2 4 weeks later and no antibodies were detected. Conclusion: Identification of platelet antibodies in the maternal blood sample is the main support in the differential diagnosis and management of NAIT. We could detect maternal platelet antibodies against paternal platelets in 40% of suspected NAIT cases, helping this way the better management of newborns and subsequent pregnancies. P099 Haemotherapy and its serological aspects of patients suffering from immunohaematological diseases ath1 , T. Dancza1 , A. Farkas2 , I. Bodork´ os1 *, M. Aleksza1 , E. Horv´ 2 2 acs , M. Tiboly2 , P. T´ oth2 , B. Gasztonyi2 . A. Gy¨ ork¨ os , M. Kov´ 1 OVSZ Zalaegerszegi Ter¨ uleti V´ erell´ at´ o, Hungary, 2 Zala Megyei K´ orh´ az Belgy´ ogy´ aszat Haematologia-Immunologia, Hungary The pathophysiological processes or the relevant chemotherapy may give rise to bone marrow failure in any immunohaematological illnesses. In such a case the necessary haemotherapy is difficult, because patients with polytransfusion and immunodeficiency are tended to alloimmunization. In our work the practice of haemotherapy to treat patients suffering from immunohaematological diseases was studied from January of 2005 up to now. The clinical and the serological data were reviewed in respect to the type of haemotherapy. The patients were administered in Department of Internal Medicine Haematology-Immunology of County Hospital Zala. Our results were compared to the summary of the Hungarian and international literatures. P100 RBC alloimmunization in chronic transfusion patients (thalassemics) A. Azarkeivan *, M.H. Ahmadi, A. Gharebaghian, S. Nasizadeh, S. Zolfaghari, M. Maghsoodlu, M.B. Ayoub Introduction: Thalassemia is the most common hereditary anemia in our country. Regular blood transfusion is a current treatment protocol & alloimmunization is one of the side effects. Material and Methods: We studied the frequency of alloimmunizaion in our thalassemic patients by screening antibody by gel method and compare the results by tube method (our traditional method). This study was done on 441 thalassemic patients. For gel method; we used plasma and micro tube system of Dia Med Company and in tube system, which was by serum & the mixture of several unknown O+ cells. Results: We had 362 major thal., (82.1%) and 79 intermedia, (17.9%); 53.1% were male 46.9% female with mean age of 22.6 year. 356 (80.7%) had regular blood transfusion. 368 (83.4%) had not any history of transfusion reaction; 7 patients (1.6%) had history of hemolytic reaction; 25 (5.7%) had allergic and 41 (9.3%) febrile reactions. 222 (50.3%) were spelenectomized. In gel method 391 (88.7%) had negative results & 50 patients (11.3%) had alloantibody. Among the positive cases 37 (74%) had one type alloantibody; 8 (16%) two antibody and 1 (2%) patient had autoantibody & 4 (8%) had unknown antibody by regular panel cells. most frequent alloantibodies were anti-Kell in 15 (28%), sub groups of Rh (E,e,C,c,Cw) in 13 (26%), anti-D in 7 (16%) and 2 patients (4%) had anti-Colton antibody. 8 patients had two antibodies which Anti-D & C in 5 (8%), anti-D & E in 1 (2%), Anti-Kell & E in 1(2%), Anti-Kell & D in 1 (2%), AntiKell & KPa in 1 (2%). In tube method: 13 (positive cases with gel method) (26%) had negative results.
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There was not any significant correlation between results of gel method and type of thalassemia, age, duration of transfusion, spelenectomy, we just had correlation between history of transfusion reaction and results of gel method (p < 0.05) Discussion: Gel method is more sensitive for finding alloantibody in multitranfused patients, because of different known antigens on O cells. In a similar study in Pakistan Bhatti worked on 161 thalassemic patients by gel method and found the total rate of 6.84% of which most were in Rh groups, 3 patients with anti-kell, anti-JSB, anti-JKa, without any correlation between age and number of transfusion or ethnicity. Ameen also studied 190 thlassemic patients in Kuwait, they had 30% alloantibody, which were 72% anti-kell, 45% anti-E, 11% autoantibody, and 49% of alloantibodies were in age gp of 2 10 years old. Our study also had similar results, 84% of alloantibodies are against Rh and Kell system. In conclusion, phenotype determination of RBC before starting of blood transfusion and careful crossmatch with Kell and subgroup of Rh in addition of ABO help to reduce alloimmunization in thalassemic patients. P101 Coincidental occurrence of RBC and HLA class I antibodies in renal transplant patients L. Kozma *, M. Lukovics, I. Bohaty. Regional Blood Transfusion Center of Debrecen, Hungary Introduction: Alloimmunization resulted in HLA and RBC antibodies is attributed to pregnancy, multiple transfusions and transplantation alike. Investigating the concordant occurrence of these two types of antibody in 101 dialized kidney patients (77 male) on the waiting list for transplantation the authors wanted to contribute to testing the hypotheses whether patients with either of these alloantibodies are prone to producing the other type as well. Material and Methods: The patients’ sera are regularly tested for HLA antibodies with complement dependent cytotoxicity (CDC) and this time 37 of them were also screened with ELISA (Abscreen class I). In selected cases if positive for Abscreen the sera were further tested for PRA and specificity (Abident class I). Samples for RBC antibodies were screened with a microcolumn gel method (DiaMed). Results: Association was found between the occurrence of HLA and RBC antibodies. In the group of patients with and without RBC antibodies the prevalence of HLA antibodies detectable with CDC was 91.7 and 14.6% respectively (p < 0.001, two-sided Fisher’s exact test). As for ELISA detected HLA antibodies, the association was not so strong 88.8 vs. 55.2% (p < 0.05). In the sample of 23 patients of the ELISA positive group with previously rejected transplant the specificity of the HLA antibodies was tested as well. Sixteen of them had donor-specific HLA class I antibody. However, it was only one of the 16 that had RBC antibody as well, whereas in the group of the remaining 7 patients six tested positive (negative correlation, p < 0.001). Conclusion: It seems that there are patients with responder phenotype that produce both kinds of antibody more readily than others, who are of non-responder type. However, the therapy after transplantation may be more effective in suppressing the immune response to the RBC antigens of less immunogenicity than to donor-specific HLA antigens, causing a dissociation in RBC and donor-specific HLA antibody formation. P102 Seroprevalence of Hepatitis C among voluntary blood donors in South-Eastern Hungary E. Szekeres *, A. Frank, M. Kosa, G. Samu, V. Szekeres. Szeged Regional Blood Center, Hungarian National Blood Transfusion Service, Szeged, Hungary Hepatitis C virus (HCV) is a prevalent pathogenic bloodborne infection with an estimated 170 million persons infected worldwide. To reduce the risk of transfusion-transmitted viral infections substantially we have screened blood donation with available highly sensitive assays for the detection of anti-HCV
2 September 2007
S119
There was not any significant correlation between results of gel method and type of thalassemia, age, duration of transfusion, spelenectomy, we just had correlation between history of transfusion reaction and results of gel method (p < 0.05) Discussion: Gel method is more sensitive for finding alloantibody in multitranfused patients, because of different known antigens on O cells. In a similar study in Pakistan Bhatti worked on 161 thalassemic patients by gel method and found the total rate of 6.84% of which most were in Rh groups, 3 patients with anti-kell, anti-JSB, anti-JKa, without any correlation between age and number of transfusion or ethnicity. Ameen also studied 190 thlassemic patients in Kuwait, they had 30% alloantibody, which were 72% anti-kell, 45% anti-E, 11% autoantibody, and 49% of alloantibodies were in age gp of 2 10 years old. Our study also had similar results, 84% of alloantibodies are against Rh and Kell system. In conclusion, phenotype determination of RBC before starting of blood transfusion and careful crossmatch with Kell and subgroup of Rh in addition of ABO help to reduce alloimmunization in thalassemic patients. P101 Coincidental occurrence of RBC and HLA class I antibodies in renal transplant patients L. Kozma *, M. Lukovics, I. Bohaty. Regional Blood Transfusion Center of Debrecen, Hungary Introduction: Alloimmunization resulted in HLA and RBC antibodies is attributed to pregnancy, multiple transfusions and transplantation alike. Investigating the concordant occurrence of these two types of antibody in 101 dialized kidney patients (77 male) on the waiting list for transplantation the authors wanted to contribute to testing the hypotheses whether patients with either of these alloantibodies are prone to producing the other type as well. Material and Methods: The patients’ sera are regularly tested for HLA antibodies with complement dependent cytotoxicity (CDC) and this time 37 of them were also screened with ELISA (Abscreen class I). In selected cases if positive for Abscreen the sera were further tested for PRA and specificity (Abident class I). Samples for RBC antibodies were screened with a microcolumn gel method (DiaMed). Results: Association was found between the occurrence of HLA and RBC antibodies. In the group of patients with and without RBC antibodies the prevalence of HLA antibodies detectable with CDC was 91.7 and 14.6% respectively (p < 0.001, two-sided Fisher’s exact test). As for ELISA detected HLA antibodies, the association was not so strong 88.8 vs. 55.2% (p < 0.05). In the sample of 23 patients of the ELISA positive group with previously rejected transplant the specificity of the HLA antibodies was tested as well. Sixteen of them had donor-specific HLA class I antibody. However, it was only one of the 16 that had RBC antibody as well, whereas in the group of the remaining 7 patients six tested positive (negative correlation, p < 0.001). Conclusion: It seems that there are patients with responder phenotype that produce both kinds of antibody more readily than others, who are of non-responder type. However, the therapy after transplantation may be more effective in suppressing the immune response to the RBC antigens of less immunogenicity than to donor-specific HLA antigens, causing a dissociation in RBC and donor-specific HLA antibody formation. P102 Seroprevalence of Hepatitis C among voluntary blood donors in South-Eastern Hungary E. Szekeres *, A. Frank, M. Kosa, G. Samu, V. Szekeres. Szeged Regional Blood Center, Hungarian National Blood Transfusion Service, Szeged, Hungary Hepatitis C virus (HCV) is a prevalent pathogenic bloodborne infection with an estimated 170 million persons infected worldwide. To reduce the risk of transfusion-transmitted viral infections substantially we have screened blood donation with available highly sensitive assays for the detection of anti-HCV