Risk factors for red blood cell alloimmunization in multi-transfused oncology patients at Moi Teaching and Referral Hospital, Kenya

Abstract

Background : Multiple blood transfusions may result in the production of alloantibodies against one or more red blood cell antigens which might make it more challenging to execute subsequent transfusions. Despite age and gender being risk factors for transfusion and being associated with alloimmunization frequency, they are not routinely taken into account before transfusion. This study assessed red blood cell alloimmunization and its association with risk factors among multi-transfused oncology patients at Moi Teaching and Referral Hospital Cancer Centre, Kenya.

Methodology : The study employed a cross-sectional study design and focused on multi-transfused oncology patients at the Moi Teaching and Referral Hospital Cancer Centre. A sample size of 162 was used in the study based on Fisher's exact test formulae and a consecutive sampling technique was applied. The gel-based antibody screening and identification were performed with "ID-Diacell I-IIIII®" panel cells. The frequency, mean, median, and dispersion of descriptive statistics were shown and the association between alloimmunization with the number of transfusions, age and sex were determined by Spearman's correlation analysis. Statistical significance was established at P< 0.05 and statistical tests were run at a 95% level of significance.

Results : This study established no association between alloimmunization and the number of transfusions (P= 0.753). There was also no association between alloimmunization and age (P= 0.159). However, there was a significant positive association between alloimmunization with gender (P= 0.01). The study had a 6.2% prevalent rate of red blood cell alloimmunization, females had a greater prevalent rate than male patients. Anti-E and anti-K were the most prevalent alloantibodies.

Conclusion and Recommendation : There is a need to improve current blood grouping and cross-match practices in most Kenyan hospitals by performing antibody screening and antibody identification tests. This study suggests routinely assessing alloimmunization in patients getting several transfusions while taking gender into account.