A retrospective study published in the journal Blood suggests that red cell alloimmunization is common among chronically transfused patients with sickle cell disease (SCD), despite the use of Rh-matched blood from minority donors. Researchers identified 146 antibodies among 182 SCD patients receiving blood matched for D, C, E, and K from African American donors. 91 who had unexplained Rh antibodies. Among patients receiving chronic transfusion therapy, 58% were alloimmunized and 45% were Rh immunized. One-third of the Rh antibodies were associated with delayed transfusion reactions. Further high-resolution RH genotyping showed that 87% of individuals experiencing Rh alloimmunization had variant alleles, suggesting that altered RH alleles led to the high prevalence of Rh alloimmunization among these patients.
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