Pinkerton P H, Coovadia A S, Goldstein J
Department of Laboratory Haematology, Sunnybrook Health Science Centre, Toronto, Ontario, Canada.
Transfusion. 1992 Nov-Dec;32(9):814-7. doi: 10.1046/j.1537-2995.1992.32993110751.x.
In view of the continuing controversy regarding the use of immediate-spin crossmatch procedures in preparing blood for transfusion to patients in whom unexpected clinically significant antibodies have not been found by antibody screening by the indirect antiglobulin test (IAT), a review of 8 years' experience with such a policy was conducted. In that period, 54,725 units of packed red cells or whole blood were transfused to 10,146 patients. Four clinically overt delayed hemolytic transfusion reactions and 18 clinically silent delayed serologic transfusion reactions were found. In 3 of the 22 patients, the offending antibody(ies) were detectable in the pretransfusion serum by an enzyme IAT, but none was detectable by routine saline IAT against either a three-cell screening panel or the transfused cells. Thus, the incorporation of saline indirect antiglobulin crossmatch would not have prevented the delayed reactions. It can be concluded that the use of a saline indirect antiglobulin crossmatch offers no significant advantage over the current policy of using only immediate-spin crossmatch for those patients whose pretransfusion serum gives negative results in a three-cell screen using a saline IAT.
鉴于在为间接抗球蛋白试验（IAT）抗体筛查未发现意外临床显著抗体的患者准备输血用血时，对于立即离心交叉配血程序的使用仍存在争议，我们对一项实施了8年的相关政策经验进行了回顾。在此期间，向10146名患者输注了54725单位的浓缩红细胞或全血。发现了4例临床明显的迟发性溶血性输血反应和18例临床无症状的迟发性血清学输血反应。在这22例患者中的3例中，通过酶IAT可在输血前血清中检测到致病抗体，但针对三细胞筛查面板或输注细胞，常规盐水IAT均未检测到任何抗体。因此，采用盐水间接抗球蛋白交叉配血并不能预防迟发性反应。可以得出结论，对于输血前血清在使用盐水IAT进行三细胞筛查时呈阴性结果的患者，使用盐水间接抗球蛋白交叉配血与目前仅使用立即离心交叉配血的政策相比，没有显著优势。
