Pusat Pengajian Sains Perubatan - Tesis

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Browsing Pusat Pengajian Sains Perubatan - Tesis by Author "Abdullah, Siti Zaleha S."

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    Study on ABO/RHD blood group and red blood cell immunization among chronic liver disease patients in Hospital Universiti Sains Malaysia
    (2022)
    Abdullah, Siti Zaleha S.
    Background: ABO and Rhesus (Rh) blood groups showed some association with various diseases. However, whether ABO and Rh blood group is associated with chronic liver disease (CLD) remains unknown. Furthermore, CLD patients commonly complicated with anemia require blood transfusion support which puts them at risk for red blood cell (RBC) alloimmunization. Variations in the frequency of RBC alloimmunization have been noted among different patient populations. Thus, this study aimed to determine the association of ABO/RhD blood grouping with CLD, the rate of RBC immunization, and their associated risk factors among CLD patients in our center. Materials and Methods: This is a case-control study involving 441 patients with CLD treated at Hospital Universiti Sains Malaysia and subjected to pre-transfusion testing from April 2012 until April 2022. Clinical and laboratory data were retrieved from the blood bank information system and patient’s record and were statistically analyzed using multiple logistic regression. P < 0.05 is considered significant. Results: A total of 441 patients were included in our study. The majority of patients were elderly, with a mean age of 57.9 (SD 12.1) years old, male (65.1%), and Malay (92.1%). The most common causes of CLD in our center were viral hepatitis (62.1%) and metabolic liver disease (25.4%). The frequency of O and B blood groups was almost equally distributed among CLD patients, at 31.5% and 31.3%, respectively. The non-O blood group was significantly associated with an increased risk of CLD (adjusted OR = 1.65, P=0.027). Twenty-four and two CLD patients were reported to have RBC alloantibodies and autoantibodies with a prevalence of 5.4% and 0.5%, respectively. Most patients developed a single alloantibody (83.3%) and belonged to the Rh blood group, which were anti-E (35.7%) and anti-c (14.3%), followed by anti-Mia (17.9%) in the MNS blood group. There was no significant factor associated with RBC alloimmunization among CLD patients identified. Conclusion: The non-O blood group was significantly associated with an increased risk of CLD. Although the prevalence of RBC alloimmunization among CLD patients was low, the vast majority developed clinically significant RBC alloantibodies, mostly from the Rh blood group. Therefore, all CLD patients requiring blood transfusion are recommended for Rh phenotyping and supplied with phenotype-matched Rh to prevent Rh alloimmunization.