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BACKGROUND:  Red blood cell (RBC) alloimmunization is common in transfused patients. Most studies report on the rate of alloimmunization in chronically transfused patients, which can be as high as 60 percent. Less is known on the incidence of clinically relevant antibodies in accidentally transfused patients. Because the probability of repeat transfusion increases with longer life expectancy, it was wondered to which extend non–chronically transfused alloimmunized patients are prone to form additional antibodies after repeat transfusion events.

STUDY DESIGN AND METHODS:  A 20‐year retrospective multicenter study was performed analyzing additional alloantibody formation, against the RH, KEL, FY, JK, and MNS blood group systems.

RESULTS:  After additional transfusions, 21.4 percent of 653 patients produced additional antibodies, resulting in 157 new antibody specificities. At the end of the study …