Can antibodies be detected before getting a transfusion to prevent reactions?
Delayed transfusion reaction is a known risk of any red blood cell transfusion. They commonly are a reaction to minor blood group antigens that are not compatible between the blood donor and transfusion recipient. Pre-transfusion testing can miss antibodies if they have declined in concentration because a long time has elapsed from a previous transfusion (very common) and then the transfusion is a re-exposure that awakens the immune system to make antibodies again (anamnestic response). Pre-transfusion testing also cannot predict the possibility of the person forming new antibodies in response to a transfusion. Antibody formation is more common in sickle cell patients than in other American patients on chronic transfusion. Risk of antibodies and transfusion reactions can be reduced by matching for some of the minor blood group antigens. See review of sickle cell transfusion issues by Elliott Vichinsky (Seminars in Hematology 2001 38(1, Suppl 1):14-22 ) or recent textbooks on Transfusio
