Pretransfusion testing, important red cells antibodies and transfusion in alloimunized recipients.

The topic of this thesis is to analyse the pretransfusion testing focusing on red cells transfusion, important red cell antibodies and transfusion in aloimmunised patients. This thesis is supposed to sum up the present knowledge of aloimmunisation in modern transfusion medicine, to provide a list of clinically significant antibodies and to determine the aloantibodies incidence in blood samples in pretransfusion testing in hospital Nemocnice České Budějovice, a.s. The thesis informs about the pretransfusion testing procedure, its requirements and recommendation for laboratory praxis. Furthermore, it describes immunohematologic laboratory methods that use pretransfusion examination. Then, it lists group systems with short description and clinically important irregular antibodies. The summary of actual state of the topic is concluded with the explanation of the term alloimunisation, causes of its emergence and recommendations for phenotypically suitable RBC transfusion preparations choice for aloimmunised patients. In the patient samples before transfusion of preparations containing RBC, we did the pretransfusion testing, i.e. blood type examination in AB0/RhD, screening of irregular antibodies against RBC antigens and compatibility test. If the antibody screening was positive, we identified them and eventually processed them through some additional RBC antigens test. After those tests, we used column (gel) agglutination and tube methods. In 7 % of the samples, the irregular antibodies were positive. More than 50 % of them came from women. Aloantibodies were found in 57,6 % of positive samples. Altogether, we identified 52 antibodies types: anti-E (23,08 %) > anti-D, -CW (13,46 %) > anti-c, -K, -Kpa (9,62 %) > anti-C, -Wra, -Jka, -S, -e, -Fyb, -P1 (1,92 %). The majority of identified aloantibodies came from the Rh (68 %) and Kell (19 %) system. Combinations were found in aloantibodies of Rh and/or Kell system. Acording to the results, polytransfused patients and fertile women can be recommended to use this ideal algorithm in the choice of transfusion preparations containing RBC: to test Rh and Kell system antibodies in the pretransfusion testing and to provide the recipients with transfusion preparations of maximal compliance of RBC antigens in above mentioned systems