Search

Background and Objectives: Cromer system antigens, a series of blood group antigens of very high frequency, are not considered to be clinically significant in transfusion. In renal transplantation only the ABO blood group antigens are considered essential. The Drori blood group antigen is present in serum and has been found to reside on the renal tubular basement membrane and Bowman's capsule. The effect of anti-Dra on the renal parenchyma has not been evaluated., Materials and Methods: A unique case of renal transplantation of an incompatible Dr(a+) kidney to a Dr(a-) patient with anti-Dra in her serum is presented., Results: Graft function was immediately good. The titer of anti-Dra remained unchanged following transplantation., Conclusion: The successful outcome of a case of a Drori (Dra)-incompatible kidney transplantation confirmed the lack of clinical significance of the anti-Dra relating to transplantation.

An example of auto-anti-Kpb in a Kp(a+b-) patient is described. The antibody present in the patient's serum and in eluates from her red cells was IgG. It did not bind complement, and did not cause in vivo hemolysis. 9 months after recognition of the autoimmune state the direct antiglobulin test had become negative and anti-Kpb was no longer detectable. It is postulated that autoimmunity involving the Kell blood group may be precipitated by antigens or enzymes of microbial origin.

An alloantibody is described which detects a high frequency blood group antigen absent from Ko cells but different from all the reported Kell and para-Kell antigens. The family study shows the antigen to be inherited but gives no information about its relationship to the Kell locus. It is suggested that this 'new' para-Kell antigen be called K22.

Three examples of an antibody were found to be detecting a red cell polymorphism probably identical to MER2. The antibodies were made by Jews originating from India and living in Israel. Two of them were sibs and the third was unrelated. All 3 had kidney disease requiring renal dialysis and regular blood transfusion. In 2 cases the antibodies were detected before dialysis was started and before the patients had been transfused. The human antibodies reacted with red cells of 90% of Israeli blood donors tested. In tests on selected blood donors, 82 English and 56 Israeli, one of the human antibodies gave almost identical reactions to those given by monoclonal anti-MER2. Anomalous reactions were probably due to anti-Bga. Two of the human antibodies completely blocked, and one partially blocked, the reaction of monoclonal anti-MER2 with MER2+ red cells.

A newborn infant of genotype P2p suffering from ABO-like hemolytic disease was born to a mother of the very rare genotype pp. The disease was severe enough to require exchange transfusions with pp blood. The mother and other members of the family with the same rare pp blood provided compatible donor blood for transfusions of the mother herself and for replacement transfusion of her affected infant. The mothers serum contained IgM molecules and also IgG molecules capable of crossing the placenta to induce a hemolytic process on the infant's red blood cells. The genotype of the P1 negative father was very likely P2P2 so that the genotype of the affected infant had to be P2p. A search of the literature revealed an earlier report from Japan in which the genotype of the P1 positive father was P1P2. As was to be expected the genotype of this affected infant was P2p.

Women with the rare blood group p are known to have an increased rate of abortions. The case of a 36-year-old woman is presented who had had 7 spontaneous abortions in the first trimester and no live child. When treated by plasma exchange begun early in pregnancy and continued until the 29th week, she delivered a normal child. Time to begin, amount and length of time necessary to continue plasma exchange in these patients are considered. In addition, the question of which fraction of the anti-PP1Pk could be responsible for abortion is discussed. To our knowledge, this is the first case of a woman of p phenotype with no live children but with multiple abortions treated by this method, which should be seriously considered in similar cases.