Prevalence Of Alloimmunization To Red Cell Antigens Among Multiply Transfused Patients With Sickle Cell Disease In Kaduna, Nigeria

Introduction: Red cell transfusion is an important modality in the treatment of complications in patients with Sickle cell disease (SCD) or Thalassaemia. However, this is associated with alloimmunization, resulting in destruction and immune-mediated clearance of the destroyed RBCs. Alloimmunization to RBC antigens complicate RBC crossmatching and delays the process of providing compatible blood for transfusion.

Aim: To determine the prevalence and pattern of alloimmunization in Multiply Transfused patients with SCD in Kaduna state.

Methods: A cross-sectional descriptive study of One hundred and thirty-one (131) individuals with SCD who had received 10 or more units of packed cells transfusions. Total Lifetime Transfusion (TLT) was defined as the total number of blood units received over a whole lifetime. Red cells were typed for ABO and Rh blood groups and Indirect antiglobulin test (IAT) for antibody screening using the saline spin tube technique and identification was done with the 3 cell Maxiscreen and 10 cell identification panel. Results were analysed using Jeffrey’s Amazing Statistical Programme (JASP) version 0.14.1, Dec 2020, statistical software.

Results: The prevalence of red cell alloimmunization was 15.3% while the risk of alloimmunization per unit of blood transfused was 1.2%. Ten (10) types of alloantibodies were identified and Anti-Lea was the most frequently occurring antibody (3%).

Conclusion: There is a high prevalence of alloimmunization among patients with SCD. Therefore, multiply transfused individuals should undergo screening for the most commonly occurring clinically significant antibodies.