Determination of the Risks of Post-Transfusion Allo-Immunization in the Rhesus and Kell Systems: Case of Recipients of the Regional Hospital of Bafoussam

Abstract

<i>Background</i>: Blood transfusion according to the World Health Organization is the transfer of blood or blood constitute from an individual donor to another transfused. Despite the efforts made in the field of immuno-haematology, the transfusion of packed red blood cells or whole blood brings foreign antigens to the recipients. The risk of occurrence of anti-erythrocyte allo-immunization is therefore greater in polytransfused subjects and increases with the number of bags of packed red blood cells transfused. The main objective was to determine the risks of posttransfusion allo-immunization of the Rhesus and Kell systems in recipients of the HRB blood bank. <i>Methodology</i>: We conducted a descriptive and cross-sectional study by successive recruitment over a period of 10 months including a one-month data collection period during which 145 participants (81 donors and 64 blood recipients) were recruited. A venous blood sample was taken on an EDTA tube and dry. ABO blood groups followed by Rhesus and Kell phenotypes were determined in the tube. <i>Results</i>: Out of the 81 donors, 82.70% (67) were men, the age group [20-30] years was more represented 56.80% (46); the familiar donor status was the most representative at 48.10% (39). Of the 64 recipients, the male sex was the most representative 53.13% (34); the age group [00-10] years was more represented, i.e. 23% (15). Blood group O was more representatives, ie 51.90% (42) /40.60% (26). In the Rhesus system, the Dce (Dccee) phenotype was the most represented, 58.0% (47) in donors and 59.4% (38) in recipients. The K1 antigen was present in 24.7% (20) of donors and 18.8% (12) of recipients. We obtained a risk of allo-immunization of 40.61% in the Rhesus system and 15.62% in the Kell system. Thus the risks of alloimmunization were more represented by the incompatibilities with the antigen E (21.87%), K (15.62%) and C (15.62%). The Chi-square test of independence and linear regression showed that the risk of alloimmunization increases with the number of non-compatible blood bags received with an OR: 0.98, ICOR [3.05-9.26]. <i>Conclusion</i>: In view of the various incompatibilities and high risk of occurrence of alloimmunization, Rhesus/Kell phenotyping is an effective means of preventing post-transfusion alloimmunization and improving transfusion safety and even the transfusion outcome of recipients.