IMPORTANCE OF TYPED BLOOD DONOR REGISTER IN FETAL AND NEONATAL TRANSFUSION CLINICAL PRACTICE
Keywords:typed blood donors, hemolytic disease of the fetus and newborn, intrauterine transfusion
Typed donors registry effectively facilitates and significantly accelerates the finding of an adequate unit of blood for patients with multiple clinically significant antibodies, but it is also of great importance for the preparation of an adequate unit of blood for intrauterine transfusions in hemolytic disease of the fetus. The registry is particulary important when hemolytic disease of the fetus is caused by immunization with one of the antigens of very high frequency in the population. In registries, there are usually three types of donors: negative for high frequency antigens, negative for more common antigens, and donors with IgA deficiency. Considering the need to provide adequate and timely transfusion therapy for patients with multiple red cell antibodies and/or antibodies to high-frequency antigens, and with the aim of enabling the preparation of a blood unit for intrauterine transfusion from a regular donor, the Blood Transfusion Institute of Serbia for the first time in 2012 started planning activities on the formation of the Register of Typed Blood Donors. Hemolytic disease of the fetus and newborn (HBFN) is a serious complication of pregnancy due to maternal alloimmunization to paternally inherited fetal red cell antigens, leading to fetal erythrocyte hemolysis and anemia. Untreated, progressive fetal anemia can lead to hepatosplenomegaly, cardiomegaly, cardiac decompensation, and ultimately fetal hydrops and perinatal death. According to published data a large number of red cell antibodies can lead to severe forms of HBFN. Antibodies associated with severe HBFN are mainly against antigens of the Rh system, primarily against antigen D. The severe form of HBFN is occasionally caused by other anti-Rh antibodies as well as antibodies to Kell antigens, and less often by antibodies to antigens of other blood corpuscle systems (Duffy , Kidd and MNS). Alloantibodies against more than 50 non-ABO antigens can lead to HBFN, and many red cell antigens are retroactively first identified after the birth of an infant with hydrops. It is importante to form a registry of typed donors in each country, and facilitate the communication between registries, in order to provide the appropriate blood units for severe forms of hemolytic disease of the fetus and newborn caused by rare antibodies or a combination of antibodies would be timely and possible easily.
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