Dashkova N G, Ragimov A A, Asoskova T K
Anesteziol Reanimatol. 2009 Nov-Dec(6):62-5.
The paper gives data on the frequency of A2 and A2B blood groups in the blood samples of 3590 donors and patients and on the carriage of irregular anti-A1 antibodies. To define the belonging of anti-A1 antibodies to various classes of immunoglobulins, their resistance and temperature optimum, at which the antibodies showed the highest activity, the authors examined the irregular anti-A1 antibodies-containing sera from 43 subjects with A2 and A2B blood groups. The necessity of identifying the carriage of irregular anti-A1 antibodies is determined by the fact that there may be posttransfusion reactions or complications in recipients, the carriers of such antibodies, who are transfused donor red blood cells containing the antigen A1. The risk of the development of such events is particularly great when anti-A1 antibodies are active at 37 degrees C and belong to the IgG class, i.e. they are immune; transfusion to a recipient is carried out during surgery under artificial hypothermia (below 28 degrees C). The red blood cells (A2 or A2B) from a donor having the same group should be selected for recipients having an A2 or A2B blood groups, respectively, and immune anti-A1 antibodies; if the latter are absent, in accordance with the instruction, there may be a selection of other-group donor red blood cells: 0 group red blood cells to recipients with A2 blood group and 0 or B group red blood cells to recipients with A2B blood group. An individual selection should be without fail made for the compatibility of bloods from a donor and a recipient in salt tests (at 4-8, 20-22, and 37 degrees C) and indirect Coombs' test. When plasma components (fresh frozen plasma, native plasma and its concentrate) are transfused to recipients with A2 and A2B blood groups having immune anti-A1 antibodies, one should use the same plasma group--A and AB, respectively.
该论文给出了3590名献血者和患者血样中A2和A2B血型的频率数据，以及不规则抗A1抗体的携带情况。为了确定抗A1抗体属于各类免疫球蛋白的情况、它们的抗性以及抗体表现出最高活性时的最适温度，作者检测了43名A2和A2B血型受试者含有不规则抗A1抗体的血清。确定携带不规则抗A1抗体的必要性在于，接受含有抗原A1的供体红细胞输血的此类抗体携带者可能会发生输血后反应或并发症。当抗A1抗体在37℃时具有活性且属于IgG类（即它们具有免疫性），且在人工低温（低于28℃）手术期间给受血者输血时，发生此类事件的风险尤其大。对于具有A2或A2B血型且有免疫性抗A1抗体的受血者，应分别选择具有相同血型（A2或A2B）的供体红细胞；如果不存在后者，根据说明，可以选择其他血型的供体红细胞：A2血型的受血者选择O型红细胞，A2B血型的受血者选择O型或B型红细胞。必须对供体和受血者的血液进行盐溶液试验（在4 - 8℃、20 - 22℃和37℃）和间接抗人球蛋白试验，以确保血液相容性。当给具有免疫性抗A1抗体的A2和A2B血型受血者输注血浆成分（新鲜冰冻血浆、天然血浆及其浓缩物）时，应分别使用相同血型的血浆——A和AB型。
