A UK single-centre survey of red cell antibodies in adult patients undergoing liver transplantation.

ABSTRACT

BACKGROUND AND OBJECTIVES: Red cell antibodies may complicate blood provision and liver transplantation outcome. The aim of this survey was to document red cell antibodies in adults undergoing liver transplantation and make recommendations for clinical practice. MATERIALS AND METHODS: We completed a 10-year retrospective review of adults undergoing liver transplant, in a single UK centre using 4- to 6-weekly red cell antibody screening. RESULTS: Seven hundred and thirty seven patients were reviewed 58 (7·9%) had antibodies. In 50 (6·8%) patients, the antibodies were clinically significant, and the commonest were Rhesus (49·5%) and Kell (11%). 33 patients had a single antibody, and the rest had multiple antibodies (range 2-5). Two-thirds of patients (38) had antibodies at presentation; 22% of these developed additional antibodies while on the waiting list or postoperatively. CONCLUSION: Consideration should be given to the proactive use of Rh- and K-typed blood in end-stage liver disease in order to reduce alloimmunization. In addition, regular antibody screening would enable staff to identify those with atypical antibodies and plan their transfusion support.