Which antibodies are commonly associated with delayed hemolytic transfusion reactions?

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Multiple Choice

Which antibodies are commonly associated with delayed hemolytic transfusion reactions?

Delayed hemolytic transfusion reactions arise when a patient forms alloantibodies against donor red cell antigens after exposure, and these antibodies may be present at low levels or become active after a second exposure, causing destruction of transfused cells days to weeks later. In this context, the antibodies most commonly linked to delayed reactions are Kidd and Duffy. Kidd antibodies (against Jk^a or Jk^b) are notorious for causing delayed hemolysis because they often exist at low titers and can be difficult to detect initially. They have a strong anamnestic potential: once the patient is exposed again to the corresponding antigen, antibody levels can rapidly rise, leading to destruction of transfused cells over several days. They also exhibit a dosage effect, with stronger reactions when the recipient is homozygous for the antigen. Duffy antibodies (anti-Fya or anti-Fyb) are another well-known cause of delayed hemolysis. They may not cause immediate problems during the first transfusion, but after exposure to antigen-positive units, memory responses can trigger a slower, progressive hemolysis that becomes clinically evident after several days. By contrast, antibodies against ABO antigens and many Rh antigens are more commonly associated with immediate, acute hemolytic reactions when a transfusion is mismatched. Lutherans or Sid antibodies are not among the ones most frequently implicated in delayed transfusion reactions. Kell antibodies can cause delayed reactions, but Kidd and Duffy are the classic, most commonly tested associations for the delayed type.

Delayed hemolytic transfusion reactions arise when a patient forms alloantibodies against donor red cell antigens after exposure, and these antibodies may be present at low levels or become active after a second exposure, causing destruction of transfused cells days to weeks later. In this context, the antibodies most commonly linked to delayed reactions are Kidd and Duffy.

Kidd antibodies (against Jk^a or Jk^b) are notorious for causing delayed hemolysis because they often exist at low titers and can be difficult to detect initially. They have a strong anamnestic potential: once the patient is exposed again to the corresponding antigen, antibody levels can rapidly rise, leading to destruction of transfused cells over several days. They also exhibit a dosage effect, with stronger reactions when the recipient is homozygous for the antigen.

Duffy antibodies (anti-Fya or anti-Fyb) are another well-known cause of delayed hemolysis. They may not cause immediate problems during the first transfusion, but after exposure to antigen-positive units, memory responses can trigger a slower, progressive hemolysis that becomes clinically evident after several days.

By contrast, antibodies against ABO antigens and many Rh antigens are more commonly associated with immediate, acute hemolytic reactions when a transfusion is mismatched. Lutherans or Sid antibodies are not among the ones most frequently implicated in delayed transfusion reactions. Kell antibodies can cause delayed reactions, but Kidd and Duffy are the classic, most commonly tested associations for the delayed type.

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