Why do people still make anti-D over 50 years after the introduction of Rho(D) immune globulin? A Biomedical Excellence for Safer Transfusion (BEST) Collaborative study.
DelBaugh RM., Murphy MF., Staves J., Fachini RM., Wendel S., Hands K., Bonet-Bub C., Kutner JM., Cohn CS., Cox CA., Jacquot C., Hasan RA., Lu W., Juskewitch JE., Raval JS., Rollins-Raval MA., Fung MK., Ziman A., Fermon EJ., Gorlin JB., Peters J., Dunbar NM., BEST foRmation of Anti‐D After Rhogam (RADAR) Study Investigators and the Biomedical Excellence for Safer Transfusion (BEST) Collaborative None.
BACKGROUND: Rho(D) immune globulin (RhIg) is used to reduce RhD alloimmunization in pregnancy. This study describes potential causes for RhD alloimmunization after the development and implementation of RhIg. STUDY DESIGN AND METHODS: This retrospective descriptive study investigated RhD-negative patients born in 1965-2005 with anti-D newly identified during 2018-2022. Transfusion, pregnancy, intravenous drug abuse, and transplantation were considered potential alloimmunization sources. RESULTS: There were 1200 study patients (852 females; 348 males) at 30 institutions in 5 countries (USA, Canada, UK, New Zealand, Brazil). Most patients had a single potential source of alloimmunization identified (857/1200, 71%), most commonly pregnancy among females (537/852, 63%) and transfusion among males (180/348, 52%). When multiple potential sources were included, males were more likely than females to have a history of transfusion (235/348 [68%] vs. 149/852 [17%], p