Just got a report back from the reference lab warning that a patient has a "high titer" anti Chido. We were warned that the patient may not fare well if given plasma containing products, with the possibility of an anaphylactic reaction.

Any words of wisdom on this topic would be greatly appreciated.

Just got a report back from the reference lab warning that a patient has a "high titer" anti Chido. We were warned that the patient may not fare well if given plasma containing products, with the possibility of an anaphylactic reaction.

Any words of wisdom on this topic would be greatly appreciated.

The warning that the patient has high-titre anti-Ch is irrelevant! Almost all anti-Ch have a high titre (that is why they were in the group of high titre, low avidity [HTLA] antibodies), but, very rarely, they are so avid that they react even with enzyme-treated red cells (don't believe everything you read in text books!!!!!!!).

Occasionally, very occasionally, a patient with anti-Ch will react to plasma, but it is very rare.

I would thoroughly recommend a review paper that has recently been published in Immunohematology (a fantastic review in a fantastic journal).

Mougey R. A review of the Chido/Rodgers blood Group. Immunohematology 2010; 26: 30-38.

In this, the author states,

"If transfusion of plasma components is required, there should be some consideration given to possible effects on the patient of receiving large(my bold font) volumes of plasma, such as the formation of precipitating immune complexes or anaphalaxis."

If you put "Immunohematology Journal" into your search engine, you should be able to get this article.

I hope that helps.

:D:D:D:D

Thanks Malcolm!!

My pleasure.

So would it be correct to assume that when anti-Chido or anti-Rodgers is identified that, for most platelet and plasma transfusions (not 'large volume,' however that is defined), that the antibodies are ignored? And typically, would the antibodies be neutralized by the recipient's plasma, positive for Chido/Rodgers?

FYI:

Mougey R. A review of the Chido/Rodgers blood Group. Immunohematology 2010; 26: 30-38.

http://tinyurl.com/6d8ygot

So would it be correct to assume that when anti-Chido or anti-Rodgers is identified that, for most platelet and plasma transfusions (not 'large volume,' however that is defined), that the antibodies are ignored? And typically, would the antibodies be neutralized by the recipient's plasma, positive for Chido/Rodgers?

FYI:

Mougey R. A review of the Chido/Rodgers blood Group. Immunohematology 2010; 26: 30-38.

http://tinyurl.com/6d8ygot

Yes!!

While I agree that the reactions to the plasma containing products are rare, I think it is important to keep it in mind. Several years ago, I listened to Dr. J. M. Moulds give a striking lecture over Chido-Rodgers along with some descriptions of reactions. I think it was at AABB in Miami.

I think the most important thing is to be aware that a reaction could occur and to be prepared in that event.

While I agree that the reactions to the plasma containing products are rare, I think it is important to keep it in mind. Several years ago, I listened to Dr. J. M. Moulds give a striking lecture over Chido-Rodgers along with some descriptions of reactions. I think it was at AABB in Miami.

I think the most important thing is to be aware that a reaction could occur and to be prepared in that event.

I agree - but they are VERY rare.

Why would the antibodies be neutralized by the recipient's plasma? I thought the recipient was the one with the antibody!

You are correct Mabel.

The recipient's antibodies would be neutralised by the Ch/Rg soluble antigens in the donor's plasma.

Why would the antibodies be neutralized by the recipient's plasma? I thought the recipient was the one with the antibody!

Oops!

Cheers, Pat

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