Browsing by Author "Fontes, A"
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- Prevalence of HLA antibodies in post pregnancies female blood donorsPublication . Barra, A; Barradas, A; Cardoso, E; Costa, C; Fontes, A; Gil, A; Oliveira, C; Ramalhete, L; Rodrigues, T; Sancho, MR; Silva, I; Simões, A; Trindade, HBackground: Transfusion related acute lung injury (TRALI) is known as transfusion hazard with high morbidity and mortality rate. Mainly HLA class II have been associated with TRALI. Preventive measures are in the exclusion of donor female as they carry any these antibodies. Aim: We study a group of female blood donor with prior history of two or more pregnancies (G2), one (G1) pregnancy and without any pregnancy (G0) for detection of HLA antibodies. Methods: We collected a total of 108 samples between September and December of 2010 (G2-56; G1-19 and G0-33 samples). For detection of HLA antibodies we used the LABScreen Mixed Assay which is multiplex technique that detects anti HLA Class I and II 1gG antibodies. Microparticles (beads) are coated with HLA antigens. Those beads have a combination of two dyes, and for each set of beads the dyes proportions are different so that the bead sets can be distinguished. Positivity was defined when the ratio is equal or higher than 4. Results: In the totality of the 108 study samples we found positivity for HLA class I antibodies in 22% (G2-32%, G1-26%, G0-3%) and for HLA class II antibodies in 17% of samples (G2-27%, G1-5%, and G0-6%). Positivity for both HLA class I and II antibodies was found only in G2 samples (18%) and G1 samples (5%). Our study also shows a 12% of positivity only for HLA class I antibodies (G2-14%, G1-21%, G0-3%) and a 6% of positivity only for HLA class II antibodies (G2-9%, G1-0%, G0-6%). Conclusions: Our study reveals higher prevalence of HLA class I and II antibodies in G2 population . Women with both positive HLA Class I and II antibodies have been excluded for blood donation in order to prevent TRALI in recipients. This study will continue with a higher number of samples. Idea was to test all this women to HLA class antibodies prior to each blood donation.
- Transfusion of RHD negative patients with RHD positive red cells concentrates: the HPFF, EPE Blood Department experience (2002-2010)Publication . Barra, A; Barradas, A; Cardoso, E; Costa, C; Fontes, A; Gil, A; Oliveira, C; Pereira, F; Rebelo, SBackground: In transfusion practice we should respect the ABO group and the Rh phenotype. The lack of availability of red cells concentrates [RCC] RhD negative in the quantities desired, do nol always make it possible to satisfy that requirement, especially in urgency. In our practice we never transfuse RhD in some groups of patients RhD negative, like women of childbearing age, children, newborns, patients with disease likely to need multiple transfusions [eg oncologic patients]. Alms: The purpose of this study was to assess possible alloimmunization in RhD negative receivers who were transfused with RhD positive RCC and try to interpret some findings. Methods: We included in this study all patients RhD negatives who received RhD positive RCC in our department from 2002 to 2010, all of them have been made an antibody screening by IAT and Enzyme before transfusing. We used for antibody screening the Card-ID “LISS/Coombs”, with the test cell reagents ID-Diacell I-II-III and the Card-ID “NaCl, enzyme test and cold agglutinins” with the test cell reagents Diacell I-II-III P. In case of positive results in the tests we used for antibody identification the ID-Cards “LIDSS/Coombs” with the ID-Panel and/or the “NaCl, enzyme test and cold agglutinins” with the ID-Panel P. When we had doubts in antibody indentification with the ID-Panel we tried resolve Them using the ID-Dia-Panel plus 6 (All the reagents and cards are DiaMed). The results for negative antibody screening were considered only if this was confirmed 72 hours after the transfusion with RhD positive RCC. Results: From 2002 to 2010 in our department, we transfused 177 patients RhD negative with 621 units os RhD positive RCC. Only 96 patients had inclusion criteria. They had heen transfused with 415 units RhD positive (average 4,48 units/patient), 52 (54,2%) were male and 44 (45,8%) were female. Average age was 77 years old, varying between 23 and 96 years old, 21 (21,9%) patients had positive antibody screening after transfusion and 75 (78,1%) didn’t. Those who were positive, in right (8,3%) were identified isolated anti-D antibodies, seven (7,3%) anti-D and others antibodies, one (1,0%) anti-Lua antibodies and five (5,2%) were inconclusive. Between the patients with positive antibody screening the average age was 77,5 years old, varying between 53 and 89 years old, the total of transfused RCC in this group was 101 (average 4,8 units/patient) and 11 (52,4 %) were male and 10 (47,6%) were female. The patients with negative antibody screening had an average age of 75,1 years old, varying between 23 and 96 years old, the total of transfused RCC in this group was 314 (average 4,5 units/patient) and 41 (54,7%) were male and 34 (45,3%) were female. Summary/conclusions: In our study 21,9% of RhD negative patients transfused with RCC RhD positive had a positive antibody screening. Studying this variables, we couldn’t explain why some patients develop antibodies and others don’t. Maybe in future studies we have include other variables.
- Transfusion therapy and sickle cell diseasePublication . Barra, A; Barradas, A; Cardoso, E; Costa, C; Ferreira, R; Fontes, A; Mota, M; Moura, H; Oliveira, C; Pereira, F; Rebelo, S; Rodrigues, T; Santos, L; Silva, A; Silva, I; Simões, A; Soares, F; Venâncio, BBackground: Sickle cell disease is a very common hemoglobinopathy. The main goal of transfusion therapy in sickle cell disease is to prevent thrombotic events, improve tissue oxygenation and treat anaemia complications. However the risk of all immunization is well known. Since 2001 our service has been doing a tight surveillance work in sickle cell patients, creating a database of about 15,000 studied blood donors. Aims: We want to share our experience in transfusion of sickle cell patients and highlight the importance to have a computer database with compatible donors in order to reduce all immunization in these patients. Methods: We have studied the above described donors for the following blood group systems ABO, Rh, Kell, Duffy, Kidd, MNSs, Lutheran, P (P1) and haemoglobin S. For each transfusion demand for these patients we research in our computer data base the more likely compatible donor. From January 2007 to January 2011 we studied 64 patients. To transfuse these patients we followed the protocol described above. We transfused these patients with red cells of compatible donors pre investigated. We perform pre transfusion tests in all patients. Results : Have been studied 64 patients who needed red cells transfusion, 30 were females and 34 were males. The range of ages was from 1 to 46 years old. 55 patients were black (85.9%). We have been able to transfuse these patients with red cells of 135 compatible donors from database. We performed 439 red cell concentrate (RCC) transfusions (average per patient 6.85). The patient with the biggest supply was transfused with 22 RCC and we didn’t find in this case any clinically significant red cell alloantibody. We had 7 positive antibody screenings, 2 were anti-Lea, 2 anti-E and 3 were inconclusive. Summary/Conclusions: In our study all patients with clinically significant alloantibody were previously transfused in other institution. We didn’t find any alloantibody in patients exclusively transfused in our department. Our experience transfusing sickle cell disease patients reveals that RCC compatible to antigens of the groups mentioned above greatly reduce all immunization. Hence the importance of the existence in urgency blood department of extended phenotype donors files.