Alloimmunization to Kell blood group system antigen owing to unmatched blood transfusion in a resource-poor setting

One of the major drawbacks of multiple blood transfusions in patients with thalassemia is the risk of development of alloimmunization to various red cell antigens within blood group systems such as Rh, Kell, Duffy, and Kidd. The problem is greater in developing countries because of lack of awareness and insufficient availability of specific typing antisera and antibody screening panels owing to financial constraints. It is of utmost importance to provide D, C, c, E, e, and K phenotype-matched blood in multiply transfused patients with thalassemia. This can prevent the development of antibodies against these clinically significant antigens, as antibodies can cause severe acute or delayed hemolytic transfusion reactions and create difficulties in providing a crossmatch-compatible packed red blood cell unit. The policy should preferably be adopted irrespective of financial constraints as it will pave the way for better transfusion practices and reduce the risk of adverse reactions in patients who are transfusion dependent for survival. Immunohematology2012;28:45–8.