The introduction of c, E and K antigen matching before blood transfusions appears to effectively prevent hemolytic disease of the fetus and newborn (HDFN) due to cEK alloimmunization in women under 45 , according to a recently published study in the British Journal of Haematology.
Traditionally, blood typing before transfusions focused only on ABO and Rh antigen typing. In 2020, the Netherlands implemented a policy of cEK matching for women under 45 before transfusions with the aim of preventing HDFN.
The authors aimed to assess the effectiveness of the Dutch program in preventing immunization and HDFN. Data analysis from over 4 million pregnancies since 2002 revealed a decline in the rate of cE alloimmunization since the introduction of cEK matching policies in 2020.
Learn more about HDFN causes and risk factors
The rate of c and E alloimmunization decreased from 46 per 100,000 pregnancies and 122 per 100,000 pregnancies to 30 and 89, respectively.
Rh antigens and ABO antigens are the RBC antigens most commonly associated with alloimmunization and HDFN. However, antigens such as the c, E and K antigens can also cause HDFN.
Human red blood cells (RBCs) can carry many antigens that are not present in all persons. When a woman enters into contact with RBC antigens different from her own during birth or through a blood transfusion, she can produce antibodies against that antigen (alloimmunization), which can cause HDFN in a future pregnancy.
“We previously reported that among pregnant women with anti-c, -E and -K, respectively, 49%, 37% and 83% had prior ABO-D-matched blood transfusions, which may have induced alloimmunization,” the authors wrote.
“In conclusion, we demonstrate that a reduction in the occurrence of anti- c and anti-E is achieved by a cE-matched transfusion policy.”
