A case for a national registry of red blood cell antibodies

Vox Sang. 2022 May;117(5):738-740. doi: 10.1111/vox.13250. Epub 2022 Jan 12.


Background and objectives: Red blood cell (RBC) antibody levels diminish over time and negative antibody screen are commonly seen in patients with a history of antibodies. Most hospitals do not have access to a shared registry of antibodies previously detected at other hospitals.

Materials and methods: We describe a case where the patient was found to be at high risk of bleeding during liver transplantation. Antibody screen on admission was negative but a history of anti-Jka was identified on reviewing patient's history in local registry of RBC antibodies. The surgery was pushed back to arrange for antigen-negative units. The patient received a total of 16 Jk(a-) RBC units during the admission.

Results: No acute or delayed transfusion adverse reactions were seen. However, if the history of anti-Jka identified at another local hospital was not known, approximately three-quarters of the units transfused would have been Jk(a+). Transfusing Jk(a+) units could have potentially exposed the patient to risk of developing an acute and/or delayed haemolytic transfusion reaction which could have led to significant morbidity and perhaps mortality.

Conclusion: With this case report, we build a case for developing a national registry of RBC antibodies to help improve patient safety and outcomes.

Keywords: RBC antigens and antibodies; blood safety; serological testing; transfusion reactions.

Publication types

  • Case Reports

MeSH terms

  • Erythrocytes
  • Hospitals
  • Humans
  • Isoantibodies*
  • Liver Transplantation*
  • Registries


  • Isoantibodies