What is the prevalence of delayed hemolytic transfusion reactions (DHTR)?

Updated: Sep 08, 2017
  • Author: Douglas Blackall, MD, MPH; Chief Editor: Michael A Kaliner, MD  more...
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Answer

Approximately 0.1–2% of patients who receive red blood cell transfusions develop RBC antibodies. In patients who are transfused regularly or in whom there is a mismatch between donor and recipient red blood cell antigens (eg, patients with sickle cell disease), the frequency of alloimmunization is much higher, affecting 10–38%. [5, 6] Despite the relatively high frequency of RBC alloimmunization, clinical manifestations of hemolytic transfusion reactions are rare (approximately 0.05% of patients transfused), as blood banks routinely detect RBC antibodies and provide antigen-negative units of blood for transfusion. The most frequently detected clinically significant RBC antibodies are shown in Table 2. [32]

Table 2. Frequent Clinically Significant RBC Antibodies (Open Table in a new window)

Antigen

System

Frequency Among All Detected Alloantibodies

Frequency of Antigen

(Whites)

Frequency of Antigen

(Blacks)

Potency*

E

Rh

16-40%

30%

22%

4%

K

Kell

5-40%

9%

2%

9%

D

Rh

8-33%

85%

92%

70%

c

Rh

4-15%

80%

96%

4%

Jk(a)

Kidd

2-13%

77%

92%

0.14%

Fy(a)

Duffy

4-12%

66%

10%

0.46%

C

Rh

2-10%

68%

27%

0.22%

e

Rh

2-3%

98%

98%

1%

Jk(b)

Kidd

2%

74%

49%

0.06%

S

MNSs

1-2%

55%

31%

0.08%

s

MNSs

< 1%

89%

94%

0.06%

*Percentage of antigen-negative recipients who become alloimmunized if transfused with antigen-positive units

Clinically significant DHTRs have been observed in about 1:2500 transfused patients in Germany and 1:3000 transfused patients in the Netherlands.


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