1. Red Cell Antibodies in Healthy Blood Donors
Dr. Gopal K Patidar*,
Dr. Afreen K Khan, Dr. Yashaswi Dhiman, Dr. Kapil Singh, Dr. Anjali Hazarika
Department of Transfusion Medicine, Cardio-Neuro Centre, AIIMS, New Delhi

2. Against Foreign Antigen
Antibody
Auto
Pregnancy
Transfusion
Transplantation
Naturally occurring
Immunoglobins
Allo
Against Self Antigen
Against Foreign Antigen

3. Red cell antibodies in healthy donors
Very rare, incidence: 0.2% to 0.8%
Naturally occurring antibodies.
Auto-antibodies > allo-antibodies.

4. Naturally occurring antibodies
Formed after exposure to environmental agents that mimic red cell antigens Eg.- bacteria, dust or pollen.
Usually IgM
React best at room temperature or lower.
Most of these antibodies are not clinically significant

5. Aims and objective:
Analysis of red cell antibodies in healthy blood donors at tertiary care hospital.

6. Material and Methods: Study type: Retrospective Observational Study
Duration: October 2017 to July 2018
Study population: Blood donors screened as per drug and cosmetic act India
Initial screening: Pooled O cell on Gel card
Antibody testing: Bio-Rad 3 cell and 11 cell red cell panels on gel column system

7. Results Total blood donations during study period: 18,112 donors
Total antibodies detected: (0.09%)
Alloantibodies: (0.08%)
Auto antibody: (0.01%)
Gender
Male
Female
Total
Donors
16 (0.08%)
2 (0.01%)
18 (0.09%)
Total donors
17862
250
18112

8. Results Age Range 18-30 31-40 41-50 51-65 Total No. of Donors 11 4 2 1
Total Donors
11018
5514
1315
265
18112 O A B AB
Total
Rh Pos 5 4 6 2 17
Total Donors
5600
3820
6091
1500
17011
Rh Neg 1
293
355
160
1101

9. Results
Frequencies of antibodies in healthy donors

10. Type of antibodies Type No. of donors Antibodies IgM 5
Anti-M(3), Anti-Lea, Anti-Leb + Cw
IgG 8
Anti-M(1), Anti-E, Anti-K, Auto-Ab
IgM + IgG
Anti M (3), Anti-S + Anti Lea, Anti-N + Lea
Total 18

11. Discussion 0.09% of alloantibodies in healthy donor plasma.
No history of transfusion in any of the donors.
These are antibodies are naturally occurring, low titre and clinically non-significant.

12. Comparisons with other studies
Study authors
Year of publication
Alloantibody
Makroo et al1
2018
0.09%
Kaur et al2
2017
0.047%
Pahuja et al3
2012
0.05%
Garg N et al4
2014
Present Study

13. Anti-M Most common antibody detected (38.8%) IgM >IgM+IgG > IgG.
May cause hemolysis

14. Anti-E Second most common allo-antibody (16.66%).
All are clinically significant (370C reacting).
Titre varies from 1:2 to 1:64
Naturally occurring, No history of transfusion in any donors

15. Anti-Lea and Anti Leb Naturally Occurring. Predominantly IgM
Lea antibody is frequently detected with saline-suspended cells at room temperature.
Sometimes reacts at 370C and Coombs phase more weakly than at room temperature
May cause hemolysis
Studies
Anti-Lea
Anti-Leb
Anti-Lea + Leb
Makroo et al (1) -
1.31%
Garg et al (4)
10.8%
2.1%
Present study
5.55%

16. Anti-K Studies Anti-K Makroo et al (1) - Garg et al (4) 2.1%
Present study
5.55%
Naturally occurring anti-K is rare.
Usually associated with previous infections.
In our case when donor was contacted after detection, it was revealed that donor had tuberculosis 5 yrs before.

17. Other antibodies
In three donors had multiple antibodies like, Anti-N + Anti Lea, Anti-S + Anti-Lea and Anti-Cw + anti Leb.
Suspect multiple antibodies when all or most of the screen and panel cells are positive but reactions are at different strengths or in different phases and the auto-control is negative.
All were confirmed by select cell panel.

18. Conclusions
Our study findings are equal to mostly others Indian studies.
Presence of alloantibody in donor plasma can cause haemolytic transfusion reaction in recipient’s body if large amount is transfused to them.

19. References
Makroo RN, Rajput S, Agarwal S, Chowdhry M, Prakash B, Karna P. Prevalence of irregular red cell antibody in healthy blood donors attending a tertiary care hospital in North India. Asian J Transfus Sci;12:17-20.
Kaur D, Bains L , Kandwal M , Parmar I., Erythrocyte Alloimmunization and Autoimmunization among Blood Donors and Recipients, Journal of Clinical and Diagnostic Research Mar, Vol-11(3): EC12-EC15.
Pahuja S, Kushwaha S, Sethi N , Pujani M, Jain M; Screening of blood donors for erythrocyte alloantibodies, Hematology,; 2012; 17:5,
Garg N et al. Prevalence of irregular red blood cell antibodies among healthy blood donors in Delhi population. Transf Apheres Sci (2014),

20. Thank You