• Aseem Kumar Tiwari, Dinesh Arora, Geet Aggarwal, Ravi C Dara, Gunjan Bhardwaj, Jyoti Sharma, Vijay Vohra, and Arvinder Singh Soin.
• Department of Transfusion Medicine, Medanta-The Medicity, Gurugram, Haryana, India.
• Indian J Med Res. 2020 Dec 1; 152 (6): 662-666.

Background & ObjectivesThe number of blood components required during a liver-transplant surgery is significant. It is challenging for blood transfusion services to provide the required RhD-negative red blood cells (RBCs) for recipients during the peri-operative period. This retrospective study presents safety data of transfusing RhD-positive RBCs in RhD-negative living donor liver-transplant (LDLT) recipients during the peri-operative period with six-month follow up for risk of developing alloantibodies.MethodsAll RhD-negative patients who underwent LDLT and were transfused ABO-compatible but RhD-positive RBC units between January 2012 and May 2018 were included in the study. Twenty one RhD-negative patients who received a total of 167 RhD-positive RBCs peri-operatively were chosen for alloantibody screening. All the patients were started on triple immunosuppression drugs as per the standard hospital protocol. Blood grouping, cross-match and antibody screening were done by column agglutination technique.ResultsPost-transplant antibody screen (weekly for 12 wk) was negative, and none of the patients developed anti-D alloantibodies till their last follow up (mean 21 months).Interpretation & ConclusionsOur observations suggest that it may be safe to use RhD-positive RBCs peri-operatively in RhD-negative LDLT recipients with low risk of alloimmunization.

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