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The Kell antigen system (also known as the Kell–Cellano system) is a human blood group system, that is, a group of antigens on the human red blood cell surface which are important determinants of blood type and are targets for autoimmune or alloimmune diseases which destroy red blood cells.
Mothers who are negative for the Kell 1 antigen develop antibodies after being exposed to red blood cells that are positive for Kell 1.Over half of the cases of hemolytic disease of the newborn owing the anti-Kell antibodies are caused by multiple blood transfusions, with the remainder due to a previous pregnancy with a Kell 1 positive baby.
Blood compatibility testing is routinely performed before a blood transfusion.The full compatibility testing process involves ABO and RhD (Rh factor) typing; screening for antibodies against other blood group systems; and crossmatching, which involves testing the recipient's blood plasma against the donor's red blood cells as a final check for incompatibility.
An antibody elution removes bound antibody from the surface of a red blood cell to aid in the antibody identification process. An antibody elution is a clinical laboratory diagnostic procedure which removes sensitized antibodies from red blood cells , in order to determine the blood group system antigen the antibody targets. [ 1 ]
The direct Coombs test is used to detect antibodies or complement proteins attached to the surface of red blood cells. To perform the test, a blood sample is taken and the red blood cells are washed (removing the patient's plasma and unbound antibodies from the red blood cells) and then incubated with anti-human globulin ("Coombs reagent").
Intravascular hemolysis is the state when the red blood cell ruptures as a result of the complex of complement autoantibodies attached (fixed) on the surfaces of RBCs attack and rupture RBCs' membranes, or a parasite such as Babesia exits the cell that ruptures the RBC's membrane as it goes. [4]
A clinically significant antibody is an antibody that is capable of causing in vitro hemolysis or a decreased survival of transfused donor red blood cells. [7] Antibodies to high frequency antigens can be assessed for clinical significance using the monocyte monolayer assay.
In drug-induced nonautoimmune hemolytic anemia, red blood cells (RBC) are destroyed from various non-immune mechanisms such as direct oxidative stress from certain drugs. [1] This is in contrast to drug-induced autoimmune hemolytic anemia where certain drugs result in the formation of antibodies against RBCs, resulting in hemolysis.