Alloantibodies to the human leukocyte antigens (HLA) or red blood cells (RBCs) can develop after exposure to alloantigens such as during pregnancy or transfusions. However, the association between RBC and HLA alloimmunization is not clear. In order to better understand the association, researchers tested for HLA alloimmunization in 660 inpatients (median age, 66 years)—447 with RBC alloantibodies and 213 without. Calculated panel reactive antibody (cPRA) values >90% for patients with and without RBC alloantibodies were 20.6% and 8.5%, respectively (p<0.0001). Based on multivariate logistic regression, RBC alloimmunization (adjusted OR, 1.50; 95% CI, 1.22-1.85), parity, age, history of renal disease, and non-leukoreduced transfusion products were all associated with HLA alloimmunization and a cPRA >90%. Previously alloimmunized patients should be closely monitored for new HLA antibody formation.
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