Caracterización y significación clínica de las reacciones post transfusionales por incompatibilidad de anticuerpos irregulares

Abstract

Blood transfusion is a medical procedure that involves administering whole blood or blood components into a patient's circulatory system to restore their hematologic status. Although transfusion is common and generally safe, post-transfusion reactions can occur during or after the procedure, which are caused by regular or irregular antibodies. Regular antibodies (ABO and part of Rh) are always analyzed before a blood transfusion. Irregular antibodies, which include Kell, Kidd, Duffy, and MNS among others, appear when exposed to antigens unknown to the immune system. Additionally, factors such as sex, age, and pregnancy have been found to predispose a patient to develop post-transfusion reactions. Therefore, evaluating the presence of irregular antibodies of a patient before a blood transfusion will help prevent harmful adverse effects. This study aims to characterize the adverse reactions caused by incompatibility with irregular antigens in blood transfusions. A systematic literature review was conducted, involving a bibliographic search of scientific articles in English, Spanish, and Portuguese across various databases such as PubMed, ScienceDirect, Elsevier, and Scopus. The results found in the period between 2013 and 2020 state that the most common post-transfusion reactions worldwide were allergic/anaphylactic, febrile non-hemolytic, and immunological hemolysis. The presence of irregular antibodies was 34% higher in women and was also greater in patients with a history of pregnancy. The most prevalent irregular antigens were E and Jka.