Detection of Alloantibodies Using Gel Card Technique and Its Correlation with Liver Function Tests in TransfusionDependent Thalassemia Patients

Abstract

Background: Thalassemia is a hereditary hemoglobin disorder characterized by chronic anemia that requires regular blood transfusion therapy. Repeated transfusions increase the risk of red blood cell alloimmunization and iron overload, both of which may contribute to clinical complications, particularly hepatic dysfunction. Aim: This study aimed to detect alloantibodies using the Gel Card technique and to evaluate their correlation with liver function parameters in transfusion-dependent thalassemia patients. Methods: A descriptive crosssectional laboratory-based study was conducted on 100 patients diagnosed with thalassemia in Wasit province. Venous blood samples were collected and divided for biochemical and immunohematological analysis. Serum levels of aspartate aminotransferase (AST/GOT), alanine aminotransferase (ALT/GPT), and alkaline phosphatase (ALP) were measured using the Roche cobas c111 automated analyzer. Alloantibody screening and cross-matching were performed using the Gel Card (column agglutination) technique. Results: The results showed elevated mean levels of liver enzymes (AST: 42.76 ± 15.28 U/L, ALT: 48.92 ± 17.64 U/L, ALP: 185.34 ± 52.11 U/L). Higher Gel Card reactivity (3+ and 4+) was more frequently observed among females compared to males. Statistical analysis revealed highly significant associations between Gel score and liver enzyme levels (p < 0.001). Correlation analysis demonstrated moderate positive correlations between Gel score and AST (r = 0.36), ALT (r = 0.42), and ALP (r = 0.31). Linear regression analysis indicated that Gel score significantly predicted ALT levels (R² = 0.17, p < 0.001). Conclusion: transfusion-dependent thalassemia patients showed significant liver enzyme elevation and detectable alloantibody formation. A significant association was observed between alloimmunization and liver function abnormalities, likely reflecting cumulative transfusion exposure and iron overload.