Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Vox Sang. 2012 Feb;102(2):144-9. doi: 10.1111/j.1423-0410.2011.01517.x. Epub 2011 Jul 6.
Patients receiving red-blood-cells may form antibodies against the alloantigens expressed by red-blood-cells, with the risk of serious morbidity and the need for extensive phenotype-matching in subsequent transfusions. The incidence of alloimmunization is considered variable for specific patient groups and for first time antibody formation. We therefore studied the cumulative incidence of the first formed alloantibody as a function of red-blood-cells exposure.
We performed a new-user cohort among all previously non-transfused non-alloimmunized patients that received non-extended matched (ABO and RhD) red-blood-cells transfusions from January 2005 to December 2009 in our university medical centre. Alloimmunization incidences were estimated by Kaplan-Meier survival-analysis.
A total of 3002 previously non-transfused patients received 31103 red-blood-cell units. A first time alloantibody forming event was experienced by 54 (1·8%) patients. The cumulative incidence of alloimmunization was 1·0% at 5 units, 2·4% at 10 units, 3·4% at 20 units and 6·5% at 40 units of red-blood-cells transfused.
The risk to develop a first red-blood-cells alloantibody increases up to the 40th transfusion and is similar for men and women. More data are needed to examine the risk after 40th transfusion.
接受红细胞输注的患者可能会针对红细胞表达的同种异体抗原产生抗体，从而导致严重的发病率，并需要在随后的输血中进行广泛的表型匹配。同种免疫的发生率被认为因特定患者群体和首次抗体形成而有所不同。因此，我们研究了首次形成的同种异体抗体的累积发生率作为红细胞暴露的函数。
我们在我们的大学医疗中心，对 2005 年 1 月至 2009 年 12 月期间接受非扩展匹配（ABO 和 RhD）红细胞输注的所有以前未输血且未发生同种免疫的非输血患者进行了一项新用户队列研究。通过 Kaplan-Meier 生存分析估计同种免疫发生率。
共有 3002 名以前未输血的患者接受了 31103 个单位的红细胞输注。54 名（1.8%）患者发生了首次同种异体抗体形成事件。同种免疫的累积发生率为输注 5 个单位时为 1.0%，输注 10 个单位时为 2.4%，输注 20 个单位时为 3.4%，输注 40 个单位时为 6.5%。
发生首次红细胞同种异体抗体的风险增加到第 40 次输血，男性和女性的风险相似。需要更多数据来检查第 40 次输血后的风险。
