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Antibodies against Kidd antigens may be difficult to detect because of significant variability in their molecular features, and weak in vitro expression. They have been reported to cause severe immediate or delayed hemolytic transfusion reactions, [6] with anti-Jk antibodies responsible for 13 of 44 cases of DHTR reported in the UK during 2021. [7]
Kidd antibodies are often capable of binding complement and causing intravascular hemolysis. More often, however, Kidd antibodies cause acute extravascular hemolysis. [7] They are a notorious cause of delayed hemolytic transfusion reactions, and may occur up to a week after transfusion in some instances.
Blood compatibility testing is routinely performed before a blood transfusion.The full compatibility testing process involves ABO and RhD (Rh factor) typing; screening for antibodies against other blood group systems; and crossmatching, which involves testing the recipient's blood plasma against the donor's red blood cells as a final check for incompatibility.
An antibody elution removes bound antibody from the surface of a red blood cell to aid in the antibody identification process. An antibody elution is a clinical laboratory diagnostic procedure which removes sensitized antibodies from red blood cells, in order to determine the blood group system antigen the antibody targets. [1]
Among these, a potentially life-threatening reaction is known as a hemolytic transfusion reaction. This is an immune mediated reaction where recipient antibodies attack donor red blood cell antigen(s), causing hemolysis of donor cells. The reaction may occur during, immediately after, or up to 28 days later.
Since these antibodies sometimes destroy red blood cells they can cause anemia; this test can help clarify the condition. The indirect Coombs test detects antibodies that are floating freely in the blood. [1] These antibodies could act against certain red blood cells; the test can be carried out to diagnose reactions to a blood transfusion. [1]
An acute hemolytic transfusion reaction (AHTR), also called immediate hemolytic transfusion reaction, is a life-threatening reaction to receiving a blood transfusion. AHTRs occur within 24 hours of the transfusion and can be triggered by a few milliliters of blood. The reaction is triggered by host antibodies destroying donor red blood cells.
Hemolytic disease of the fetus and newborn is similar to a transfusion reaction in that the mother's antibodies cannot tolerate the fetus's antigens, which happens when the immune tolerance of pregnancy is impaired. In many instances the maternal immune system attacks the fetal blood cells, resulting in fetal anemia.