E-ISSN: 1308-5263
Retrospective Study on Prevalence, Specificity, Sex, and Age Distribution of Alloimmunization in Two General Hospitals in Athens [Turk J Hematol]
Turk J Hematol. 2020; 37(3): 154-166 | DOI: 10.4274/tjh.galenos.2020.2019.0459  

Retrospective Study on Prevalence, Specificity, Sex, and Age Distribution of Alloimmunization in Two General Hospitals in Athens

Marianna Politou1, Serena Valsami1, Georgios Dryllis2, Maria Christodoulaki3, Christina Cheropoulou4, Abraham Pouliakis5, Maria Baka3, Konstantinos Stamoulis6
1Hematology Laboratory-Blood Bank, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
2First Internal Medicine Clinic, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
3Blood Transfusion Department, General Hospital Sismanoglio, Athens, Greece
4Blood Transfusion Department, General Hospital Thriasio, Athens, Greece
52nd Department of Pathology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Greece
6Hellenic National Blood Transfusion Center, Athens, Greece

Objective: Blood transfusion is a common lifesaving treatment but it is often complicated with alloimmunization. Previously studies in Greece have concentrated on alloimmunization in multiply transfused thalassemic patients or antenatal women. However, the relative frequency of red blood cell (RBC) alloantibodies in the general patient population has not been studied so far. The aim of the present retrospective study was to estimate the prevalence and specificity of RBC alloantibodies in a large cohort of patients in two general hospitals and their association with age, sex, and the patients’ clinic of hospitalization.
Materials and Methods: Data from 2012 to 2016 from the “Sismanogleio” and “Thriasio” general hospitals in Athens, Greece, were studied retrospectively. Statistical analysis was performed with SAS for Windows 9.4.
Results: Six hundred twenty-six patients (626/53800, 1.16%) were alloimmunized for one or more alloantibodies. The mean age was 67.99±17.56 years. Most antibodies were found in women [62.66% (438/699) in women vs. 37.34% (261/699) in men (p=0.0007)], while the vast majority of antibodies (66.81%) were found in patients aged 61-90. The most frequent antibody was anti-Kell (26.61%), followed by anti-E (16.02%), anti-D (15.02%), anti-Jka (5.87%), and anti-M (5.72%). Anti-C (81.48%, n=27) and anti-Cw (54.17%, n=24) tended to be found more often in patients with multiple antibodies. Most alloimmunized cases were found in general surgery (42.65%) and internal medicine departments (38.66%).
Conclusion: According to our results, the alloimmunization data in a general patient population in Greece were consistent with the majority of studies in the international literature. Whether a strategy at national level needs to be directed towards extending matching for the whole population or towards applying sensitive and compulsory indirect antiglobulin tests before any transfusions in order to efficiently prevent alloimmunization remains an issue of debate.

Keywords: Alloimmunization, Prevalence, Red blood cells, Alloantibodies, Specificity, Age distribution, Sex distribution, Blood transfusion


Atina’da İki Hastanede Alloimmünizasyonun Sıklığı, Özgüllüğü, Cinsiyet ve Yaş Dağılımı Üzerine Geriye Dönük Çalışma

Marianna Politou1, Serena Valsami1, Georgios Dryllis2, Maria Christodoulaki3, Christina Cheropoulou4, Abraham Pouliakis5, Maria Baka3, Konstantinos Stamoulis6
1Hematology Laboratory-Blood Bank, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
2First Internal Medicine Clinic, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
3Blood Transfusion Department, General Hospital Sismanoglio, Athens, Greece
4Blood Transfusion Department, General Hospital Thriasio, Athens, Greece
52nd Department of Pathology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Greece
6Hellenic National Blood Transfusion Center, Athens, Greece

Amaç: Kan transfüzyonu sık uygulanan hayat kurtarıcı bir tedavidir ancak sıklıkla alloimmünizasyon ile komplike olur. Yunanistan’da daha önce yapılan çalışmalar çoklu transfüze edilen talasemik hastalar ve antenatal kadınlar üzerine yoğunlaşmıştır. Ancak şimdiye kadar genel hasta popülasyonunda eritrosit alloantikorlarının görece sıklığı araştırılmamıştır. Bu geriye dönük çalışmanın amacı iki hastanedeki büyük bir hasta grubunda eritrosit alloantikorlarının sıklığı, özgüllüğü yanında yaş, cinsiyet ve hastaneye yatış kliniği ile ilişkisi tahmin etmektir.
Gereç ve Yöntem: Atina, Yunanistan’da bulunan Sismanogleio ve Thriasio hastanelerinin 2012-2016 dönemine ait verileri geriye dönük olarak incelendi. İstatistiksel analiz SAS for Windows 9.4 yazılım platformu ile yapıldı.
Bulgular: Altı yüz yirmi altı hastanın (626/53800, %1,16) bir veya daha fazla alloantikor ile alloimmünize olduğu saptandı. Ortalama yaş 67,99±17,56 idi. Kadınlarda antikor saptanma oranı (%62,66; 438/699) erkeklere (%37,34; 261/699) kıyasla daha fazlaydı (p=0,0007) ve antikorların büyük çoğunluğu (%66,81) 61-90 yaş grubunda izlendi. En sık anti-Kell antikoru (%26,61) saptanırken bunu anti-E (%16,02), anti-D (%15,02), anti-Jka (%5,87) ve anti-M (%5,72) izledi. Anti-C (%81.48, n=27), anti-Cw (%54,17, n=24) çoklu antikorlu hastalarda daha sık bulunma eğilimindeydi. Alloimmünize olgularının çoğu genel cerrahi (%42,65) ve iç hastalıkları (%38,66) kliniğinde bulundu.
Sonuç: Sonuçlarımıza göre, Yunanistan’da bulunan genel hasta popülasyonundaki alloimmünizasyon oranları uluslararası literatürdeki çalışmaların çoğu ile uyumludur. Alloimmünizasyonun etkin biçimde önlenmesi için ulusal düzeydeki stratejinin tüm popülasyonda genişletilmiş uyum arama veya tüm transfüzyonların öncesinde zorunlu indirekt antiglobulin testine yönlendirilmesi konuşu tartışmalıdır.

Anahtar Kelimeler: Alloimmünizasyon, Prevalans, Eritrosit, Alloantikor, Özgüllük, Yaş dağılımı, Cinsiyet dağılımı, Kan transfüzyonu


Marianna Politou, Serena Valsami, Georgios Dryllis, Maria Christodoulaki, Christina Cheropoulou, Abraham Pouliakis, Maria Baka, Konstantinos Stamoulis. Retrospective Study on Prevalence, Specificity, Sex, and Age Distribution of Alloimmunization in Two General Hospitals in Athens. Turk J Hematol. 2020; 37(3): 154-166

Corresponding Author: Marianna Politou, Greece


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