Autoantibodies: selection of blood for individual compatibility

BACKGROUND: Screening and identification of antierythrocyte antibodies before transfusion of erythrocyte-containing components contributes to the most accurate selection of donor blood components compatible for the recipient, which reduces the risk of posttransfusion reactions and complications.

CLINICAL CASE DESCRIPTION: Female patient X., age 62, was admitted to the hematology department with a diagnosis of “Iron deficiency anemia, unspecified”. Autoantibodies and antierythrocytic antibodies of the Rhesus system were identified — anti-e antibodies. Conducting a test for individual compatibility of blood components is difficult: the incompatibility of blood components in an indirect antiglobulin test is due to the presence of autoantibodies.

CONCLUSION: An integral part of specialized medical care is blood transfusion, which is based on the immunohematological compatibility of the donor and recipient. At the same time, the safety of transfusion of donated blood and its components is the most important principle of providing transfusion care in medical organizations. Screening of antierythrocyte alloantibodies is a mandatory pretransfusion test. However, the antibody identification process is difficult in the presence of thermal autoimmune antibodies in the plasma under study. To confirm the presence of autoantibodies in the test sample, a direct antiglobulin test (DAGT) is necessary. The standard way to “get rid” of autoimmune antibodies is to use the absorption–elution method, however, the complexity of the technique limits its use in immunohematology laboratories in routine practice.