الفهرس 
Immune Hemolytic AnemiaOnly 14 pages are availabe for public view
 |  | from | 124 |  |  |
| | | from | 124 | | |
Abstract
Background: Autoantibodies in patients with autoimmune hemolytic anemia (AIHA) is encountered with difficulties in ABO grouping and cross matching, it may mask the presence of alloantibodies leading to hemolytic transfusion reaction. Therefore, an efficient and time saving method is required to detect alloantibodies underlying autoantibodies for safe transfusion in AIHA.
Aim: to compare the effeciency of different alloadsorption techniques in detection of alloantibodies after complete removal of autoantibodies.
Materials and Methods: Seventy patients with warm AIHA were enrolled in this study; antibody screening was done by using screening cells (I+II+III cells). Allogenic adsorption was performed using conventional, PEG and LISS/papain methods followed by rescreening to ensure the adsorption of the autoantibodies, whenever screening test revealed alloantibodies; antibody identification was done. Antibody identification and cross matching with phenotyped red cells were done by the plasma obtained with this method. The best adsorption method was chosen depending on its ability to preserve the alloantibody.
Results: a significant difference was found between the three alloadsorption methods regarding number of alloadsorptions and time for complete autoantibodies removal. PEG showed the lowest mean number of alloadsorptions (2.6 ± 1.2) followed by LISS/papain (3.1± 1.5) compared with the conventional method (3.7± 1.4) (p<0.001). As regards the time PEG was the most rapid method (38.6 ± 17.6 min) followed by LISS/papain (45.9 ± 22.8 min) then the conventional method (110.1 ± 14.4 min) (p<0.001). However, no significant difference was found between PEG and LISS/papain (p=0.014). Alloantibodies were detected in 35% of cases with predominance of anti Rh system (61%) mainly anti c and anti E. Alloantibodies belong to Rh and Kidd were best identified in adsorbed plasma by LISS/papain in comparison to PEG and the conventional techniques.
Conclusion: Among the evaluated methods, LISS/Papain displayed the highest diagnostic accuracy, sensitivity and specificity of alloantibody detection. Compared with the conventional method, LISS/papain and PEG minimized the time and number of alloadsorptions enhancing TAT and reducing the labor of pre-transfusion testing in AIHA.