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Kell antigens are important in transfusion medicine, autoimmune hemolytic anemia and hemolytic disease of the newborn (anti-Kell). Anti-K is the next most common immune red cell antibody after those in the ABO and Rh system. Anti-K typically presents as IgG class alloantibody. Individuals lacking a specific Kell antigen may develop antibodies ...
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.
Anti-Kell hemolytic disease of the newborn is most commonly caused by anti-K 1 antibodies, the second most common form of severe HDN. Over half of the cases of anti-K 1 related HDN are caused by multiple blood transfusions. Antibodies to the other Kell antigens are rare. [19] Anti-Kell can cause severe anemia regardless of titer. [22]
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").
Coombs - after birth, the newborn will have a direct Coombs test run to confirm antibodies attached to the infant's red blood cells. This test is run from cord blood. [5] In some cases, the direct Coombs will be negative but severe, even fatal HDN can occur. [15] An indirect Coombs needs to be run in cases of anti-C, [16] anti-c, [16] or anti-M ...
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.
Blood testing for the mother is called an Indirect Coombs Test (ICT) or an Indirect Agglutination Test (IAT). This test tells whether there are antibodies in the maternal plasma. If positive, the antibody is identified and given a titer. Critical titers are associated with significant risk of fetal anemia and hydrops. [14]
Anti-Kell hemolytic disease of the newborn [1] Rhesus c hemolytic disease of the newborn [1] Rhesus E hemolytic disease of the newborn [1] Other blood group incompatibility (RhC, Rhe, Kidd, Duffy, MN, P and others) [1] Alloimmune hemolytic blood transfusion reactions (i.e., from a non-compatible blood type) [1]