Investigation and characteristics of 115 cases with unexpected antibodies for improving transfusion strategies: a retrospective study
- 1Department of Blood Transfusion, Shanghai Geriatric Medical Center, Shanghai, 201104 China
- 2Department of Blood Transfusion, Zhongshan Hospital, Fudan University, Shanghai, 200032 China
Abstract
Objective: To investigate the prevalence and distribution characteristics of unexpected antibodies through a retrospective analysis of 115 positive cases and explore transfusion strategies for patients with unexpected antibodies.
Methods: Clinical data of 33,013 patients who underwent unexpected antibody testing in a hospital from May 2023 to October 2025 were collected, and 115 positive cases were retrospectively analyzed. The overall positivity rate of unexpected antibodies and their distribution across different sexes and ABO blood types were statistically analyzed. The effects of transfusion history, pregnancy history, disease types, and treatment history on the production of unexpected antibodies were examined.
Results: Among 33,013 tested individuals, 115 were positive for unexpected antibodies, yielding an overall positivity rate of 0.35%. The positive rate was 0.28% (44/15,932) in men and 0.42% (71/17,081) in women, with a statistically significant difference (P < 0.05). Among the 115 patients with positive, result, 44 were men (38.3%) and 71 were women (61.7%), showing a significant difference in gender distribution (P < 0.05). The positivity rate of unexpected antibodies differed significantly among ABO blood types (P = 0.006). Sixty patients (52.2%) had a history of transfusion, while 55 (47.8%) had no transfusion history, with no significant difference (P > 0.05). Regarding antibody specificity, 39 cases (33.9%) involved Rh blood group system antibodies, 34 cases (29.6%) involved MNS blood group system antibodies, 26 cases (22.6%) had undetermined specificity, and the remaining cases involved Duffy, Lewis, and other blood group system antibodies. In terms of disease distribution, positive patients were predominantly concentrated in four categories: digestive system diseases, hematological diseases, cardiovascular and cerebrovascular diseases, and obstetrics and gynecology diseases.
Conclusion: Transfusion history and pregnancy history are the major contributing factors to the development of unexpected antibodies. The positive rate of unexpected antibodies varies among individuals with different ABO blood groups, with the highest rate observed in those with blood type A. Antibodies from different blood group systems exhibit distinct characteristics. Blood transfusion departments should develop individualized transfusion strategies based on antibody specificity and patients’ clinical features to maximize the safety of clinical transfusion.
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BibTeX
@article{wen2026investigation,
title = {{Investigation and characteristics of 115 cases with unexpected antibodies for improving transfusion strategies: a retrospective study}},
author = {Caili Wen and Yiying Tang and Lijia Zhu and Rong Zhou},
journal = {BMC Immunology},
year = {2026},
month = jul,
doi = {10.1186/s12865-026-00888-8},
url = {https://doi.org/10.1186/s12865-026-00888-8},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Investigation and characteristics of 115 cases with unexpected antibodies for improving transfusion strategies: a retrospective study
AU - Caili Wen
AU - Yiying Tang
AU - Lijia Zhu
AU - Rong Zhou
PY - 2026
DA - 2026/07/20
JO - BMC Immunology
DO - 10.1186/s12865-026-00888-8
UR - https://doi.org/10.1186/s12865-026-00888-8
AB - Objective: To investigate the prevalence and distribution characteristics of unexpected antibodies through a retrospective analysis of 115 positive cases and explore transfusion strategies for patients with unexpected antibodies. Methods: Clinical data of 33,013 patients who underwent unexpected antibody testing in a hospital from May 2023 to October 2025 were collected, and 115 positive cases were retrospectively analyzed. The overall positivity rate of unexpected antibodies and their distribution across different sexes and ABO blood types were statistically analyzed. The effects of transfusion history, pregnancy history, disease types, and treatment history on the production of unexpected antibodies were examined. Results: Among 33,013 tested individuals, 115 were positive for unexpected antibodies, yielding an overall positivity rate of 0.35%. The positive rate was 0.28% (44/15,932) in men and 0.42% (71/17,081) in women, with a statistically significant difference (P < 0.05). Among the 115 patients with positive, result, 44 were men (38.3%) and 71 were women (61.7%), showing a significant difference in gender distribution (P < 0.05). The positivity rate of unexpected antibodies differed significantly among ABO blood types (P = 0.006). Sixty patients (52.2%) had a history of transfusion, while 55 (47.8%) had no transfusion history, with no significant difference (P > 0.05). Regarding antibody specificity, 39 cases (33.9%) involved Rh blood group system antibodies, 34 cases (29.6%) involved MNS blood group system antibodies, 26 cases (22.6%) had undetermined specificity, and the remaining cases involved Duffy, Lewis, and other blood group system antibodies. In terms of disease distribution, positive patients were predominantly concentrated in four categories: digestive system diseases, hematological diseases, cardiovascular and cerebrovascular diseases, and obstetrics and gynecology diseases. Conclusion: Transfusion history and pregnancy history are the major contributing factors to the development of unexpected antibodies. The positive rate of unexpected antibodies varies among individuals with different ABO blood groups, with the highest rate observed in those with blood type A. Antibodies from different blood group systems exhibit distinct characteristics. Blood transfusion departments should develop individualized transfusion strategies based on antibody specificity and patients’ clinical features to maximize the safety of clinical transfusion.
SN - 1471-2172
ER -