Au W Y, Liu C L, Lo C M, Fan S T, Lam M F, Lam C K
Department of Medicine, Queen Mary Hospital, University of Hong Kong.
Transplantation. 2003 Jul 27;76(2):324-6. doi: 10.1097/01.TP.0000071851.07503.FB.
Red blood cell (RBC) alloantibodies are present in up to 14% of white recipients of liver transplants and can cause severe delayed hemolysis.
A retrospective survey showed 17 cases (8.8%) of RBC alloantibodies in 192 consecutive Chinese recipients of liver transplants compared with a background hospital incidence of 3.7%.
The spectrum of RBC alloantibodies in Chinese patients was different than in white patients, with no anti-D or anti-K antibodies but a significant incidence of anti-Mi (29%) antibodies. There was a significantly increased incidence of transfusions in RBC alloantibody positive cases. Delayed hemolysis also resulted in higher day-7 bilirubin levels. A total of 7 to 86 antigen-positive units were issued in five RBC alloantibody cases, including three early deaths. Seven cases in the RBC alloantibody negative group, but none in the positive group, were salvaged by regraft.
Blood banks servicing transplant centers should be aware of ethnic patterns in RBC alloantibodies. Delayed hemolysis may jeopardize patient survival as the result of difficult postoperative stabilization, especially in cases requiring massive transfusion.
红细胞（RBC）同种抗体在高达14%的肝移植白人受者中存在，可导致严重的迟发性溶血。
一项回顾性调查显示，在192例连续的中国肝移植受者中，有17例（8.8%）出现红细胞同种抗体，而医院背景发病率为3.7%。
中国患者的红细胞同种抗体谱与白人患者不同，无抗-D或抗-K抗体，但抗-Mi（29%）抗体的发生率显著。红细胞同种抗体阳性病例的输血发生率显著增加。迟发性溶血还导致第7天胆红素水平升高。5例红细胞同种抗体病例共发放了7至86个抗原阳性单位，其中包括3例早期死亡。红细胞同种抗体阴性组有7例通过再次移植获救，而阳性组无一例获救。
为移植中心服务的血库应了解红细胞同种抗体的种族模式。迟发性溶血可能因术后稳定困难而危及患者生存，尤其是在需要大量输血的情况下。
