Avaliação da aloimunização eritrocitária em pacientes atendidos em um hospital universitário brasileiro

Abstract

Introduction: The need to reduce transfusion reactions has led to the use of increasingly accurate immunohematological techniques in transfusion routine, in addition to the improvement of alloimmunization prevention strategies, which demands knowledge of the characteristics of the alloimmunized population. Thus, the objectives of this study were to determine the frequency of alloimmunization in patients cared at a Brazilian university hospital, investigate the demographic, clinical and epidemiological characteristics of irregular antibody screening (IAS) positive patients, as well as to assess the frequency and identify erythrocyte antigens and anti-erythrocyte antibodies in the population. Material and Methods: A retrospective observational study, including all IAS positive patients cared at the Transfusion Agency of the Clinical Hospital of the Federal University of Uberlandia, was conducted between the months of January 2019 and December 2020. Results: The prevalence of alloimmunization in the study period was 1.7%. Of the 201 IAS positive patients, alloimmunization was more common in women (64.2%) than in men (35.8%). Blood groups A (39.8%) and O (38.8%), Rh positive (69.1%) predominated and about half (48.2%) of the patients were transfused as a result of preoperative procedures. Among the clinically significant alloantibodies characterized, the most frequently found were anti-D (27.2%), anti-E (15%) and anti-Kell (11.5%). Of these, 30.6% had multiple antibody associations, with anti-D and anti-C being the most common combination. Erythrocyte immunophenotyping was performed in 79 patients, and the most frequent antigens detected were C (27%), E (23.5%) and Kell (15.5%). Of the 14 pregnant women evaluated, most were multiparous, 85.7% had anti-D as the most prevalent antibody, as well as A-negative blood type (33.3%). Conclusion: Antibody screening and its specific identification, associated with erythrocyte immunophenotyping, are necessary for a better understanding of the alloimmune population, which can ensure greater safety and efficacy to transfusion therapy.