Selection of GP. Mur antigen-negative RBC for blood recipients with anti-‘Mia’ records decreases transfusion reaction rates in Taiwan

Objectives: To evaluate the clinical significance of GP. Mur antigen-negative blood selection for transfusion in patients with anti-‘Mia’ records. Background: The GP. Mur RBC phenotype is prevalent (7·3%) in Taiwan. Antibodies against GP. Mur (anti-‘Mia’) are identified in 1·24% of our population, and anti-‘Mia’ screening using GP. Mur RBC has been routine for Taiwan’s blood banks. However, due to the lack of commercial antibodies, only cross-matching was used to prevent transfusion of GP. Mur-positive blood to patients with anti-‘Mia’ in most hospitals. There is still a risk of GP. Mur-positive RBC exposure and subsequent anti-‘Mia’-related transfusion reactions. Methods: Since February 2014, GP. Mur antigen-negative RBCs identified by reaction with anti-‘Mia’-positive serum were selected for blood recipients with anti-‘Mia’ records. The transfusion reactions between January 2013 and January 2014 were compared with those that occurred between February 2014 and July 2015. Results: The transfusion reaction rate was significantly higher in anti-‘Mia’-positive blood recipients compared to total subjects receiving an RBC transfusion before GP. Mur-negative donor RBC selection. After antigen-negative RBC selection, the transfusion reaction frequency in subjects with anti-‘Mia’ became similar to total blood recipients. IgG form anti-‘Mia’ antibodies were present in all cases of probable anti-‘Mia’-related transfusion reactions. The time required for anti-‘Mia’ boosting after transfusion was around 4–21 days. Conclusion: Selection of GP. Mur-negative RBC for transfusion to patients with anti-‘Mia’ records could decrease the rate of transfusion reaction and antibody boosting. This procedure should be incorporated into blood bank routines in areas where anti-‘Mia’ is prevalent.