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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]
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.
There are many different varieties of abnormal reactions to blood transfusion. 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.
Kidd antibodies are dangerous as they are capable of causing severe acute hemolytic transfusion reactions. They are unique in that they are capable of dropping to low or even undetectable levels after several months following an exposure. [5] Thus, on pre-transfusion testing, an anti-Jka or -Jkb may go undetected.
Once a woman has antibodies, she is at high risk for a transfusion reaction. [42] For this reason, she must carry a medical alert card at all times and inform all doctors of her antibody status. [citation needed] "Acute hemolytic transfusion reactions may be either immune-mediated or nonimmune-mediated.
Typically mild but may be serious, even fatal. Although these usually occur immediately they may occur after a delay (up to 24 hours). These reactions are usually caused by anti-Fy a or anti-Fy b. anti-Fy3 may cause acute or delayed hemolytic transfusion reactions, but only rarely. Anti-Fy5 may also cause delayed hemolytic transfusion reactions ...
It is therefore common to select c-negative and E-negative blood for transfusion patients who have an anti-E and lack the c antigen (in general, a patient will not produce antibodies against their own antigens). Anti-c is a common cause of delayed hemolytic transfusion reactions. [15]
This antibody-antigen reaction can be detected through visible clumping or destruction of the red blood cells, or by reaction with anti-human globulin. Along with blood typing of the donor and recipient and screening for unexpected blood group antibodies , cross-matching is one of a series of steps in pre-transfusion testing.