Browsing by Author "Delaney, Meghan"

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    The Role Of Improved Pre-Transfusion Testing In The Prevention Of Delayed Serologic Transfusion Reactions Among Blood Recipients In Uganda: A Randomized Controlled Trial (IPAT Study)
    (ISBT Science Series, 2019) Natukunda, Bernard; Ndeezi, Grace; Er, Lay See; Bajunirwe, Francis; Teramura, Gayle; Delaney, Meghan
    The goal of pre-transfusion testing (PTT) is to provide patients with beneficial and safe transfusions. In Uganda, PTT includes ABO/RhD typing plus room temperature (RT) saline cross-matches without red-blood-cell (RBC) alloantibody screening. The aim of the IPAT study was to assess the role of improved PTT in the prevention of delayed serologic transfusion reactions (DSTRs).In this randomized controlled trial, patients at Mbarara Hospital in Uganda, with a history of RBC exposure, were randomized 1:1 to have either RBC alloantibody screening (SCREEN group) or room temperature saline cross-matches (CONTROL group) during PTT. ‘Home-made’ reagent RBCs from group O RhD-positive volunteers were used for antibody screening in the indirect antiglobulin test. Participants were evaluated for RBC alloantibody production 7–14 days after transfusion. Post-transfusion haemoglobin estimation and direct antiglobulin tests (DATs) were also performed.We randomized 220 patients to either the SCREEN or CONTROL group. Both study arms had similar demographic and transfusion characteristics at baseline. There were 19 (17·3%) individuals in the CONTROL group with DSTRs compared to 8 (7·3%) in the SCREEN group at the time of follow-up (P = 0·02). Overall, post-transfusion DATs were positive in 7 (3·5%) patients but there was no associated decrease in haemoglobin levels.Red-blood-cell alloantibody screening is associated with occurrence of significantly fewer DSTRs. The use of ‘home-made’ reagent cells during PTT in Uganda is feasible. We recommend a change in the local PTT policy to consider the introduction of RBC alloantibody screening.
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    The utility of 'home-made' reagent red blood cells for antibody screening during pre-transfusion compatibility testing in Uganda.
    (African Health Sciences, 2021-06) Natukunda, Bernard; Wagubi, Robert; Taremwa, Ivan; Okongo, Benson; Mbalibulha, Yona; Teramura, Gayle; Delaney, Meghan
    Background: The WHO recommends that pre-transfusion testing should include ABO/RhD grouping followed by screen- ing for red blood cell (RBC) alloantibodies using the indirect antiglobulin test (IAT). However, in Uganda, current practice does not include RBC alloantibody screening. Objective: To assess the utility of ‘home-made’ reagent RBCs in alloantibody screening. Materials and methods: In a laboratory-based study, group O RhD positive volunteer donors were recruited and their extended phenotype performed for C, c, E, e, K, Fya, Fyb Jkb, S and s antigens. These ‘home-made’ reagent RBCs were preserved using Alsever’s solution and alloantibody detection tests performed. For quality assurance, repeat alloantibody screening of patients’ samples was done at Bloodworks Northwest Laboratory in Seattle, United States. Results: A total of 36 group O RhD positive individuals were recruited as reagent RBC donors (median age, 25 years; range, 21 – 58 years; male-to-female ratio, 1.6:1). Out of the 311 IATs performed, 32 (10.3%) were positive. Confirmatory IAT testing in the United States was in agreement with the findings in Uganda. Conclusion: Use of ‘home-made’ reagent RBCs during pre-transfusion testing in Uganda is feasible. We recommend the introduction of pre-transfusion IAT alloantibody screening in Uganda using ‘home-made’ reagent RBCs to improve trans- fusion safety.