Wilkemeyer I, Pruss A, Kalus U, Schroeter J
University Tissue Bank, Institute of Transfusion Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Cell Tissue Bank. 2012 Aug;13(3):447-52. doi: 10.1007/s10561-012-9326-0. Epub 2012 Jul 17.
Defined serological blood tests of deceased cornea donors are required to minimize the risk of viral infections of a transplant recipient as much as possible. Haemolysis, autolysis and bacterial contamination, may produce significant changes of post-mortem blood samples, which may lead to false serological test results. Pre- and post-mortem findings from the same cornea donors of the University Tissue Bank of the Charité in the years 2004-2009 (n = 487) were retrospectively analyzed and compared. The test results from pre-mortem blood samples were defined as the reference for the post-mortem blood test. Of 487 cornea donors, there were a total of 21 cases (4.3%) with discrepancies between serological test results from pre- and post-mortem blood samples. Of these, 7 values referred to the HBsAg-testing, 3 to the anti-HBs-, 1 to the anti-HBcIgG + IgM-, 1 to the anti-HCV-, 4 to the anti-HIV 1/2- and 5 to the TPLA-findings. False negative results within post-mortem serology occurred in 4 of 487 cases (0.8%). False positive results within the post-mortem blood samples occurred at a much more frequent rate, with 17 of 487 cases (3.5%). Discrepancies between serological pre- and post-mortem blood tests occur mainly due to the use of non-validated test systems. Therefore, it seems reasonable to test pre- and post-mortem blood samples serologically, whenever possible, at the same time, regardless of the sample age. Positive results, regardless of the sample type, should always be retested with validated confirmation tests (e.g. NAT), in order to differentiate between false and true positive results.
需要对已故角膜供体进行特定的血清学血液检测，以尽可能降低移植受者发生病毒感染的风险。溶血、自溶和细菌污染可能会使死后血液样本产生显著变化，从而导致血清学检测结果出现错误。对2004年至2009年期间（n = 487）柏林夏里特大学组织库中同一角膜供体的生前和死后检查结果进行了回顾性分析和比较。生前血液样本的检测结果被定义为死后血液检测的参考标准。在487名角膜供体中，生前和死后血液样本的血清学检测结果共有21例（4.3%）存在差异。其中，7项数值涉及乙肝表面抗原（HBsAg）检测，3项涉及乙肝表面抗体（抗-HBs），1项涉及乙肝核心抗体IgG + IgM，1项涉及丙肝抗体（抗-HCV），4项涉及艾滋病病毒1/2抗体（抗-HIV 1/2），5项涉及总磷脂酶A检测（TPLA）结果。死后血清学检测出现假阴性结果的有487例中的4例（0.8%）。死后血液样本出现假阳性结果的频率要高得多，487例中有17例（3.5%）。生前和死后血液血清学检测结果的差异主要是由于使用了未经验证的检测系统。因此，无论样本保存时间多长，尽可能同时对生前和死后血液样本进行血清学检测似乎是合理的。无论样本类型如何，阳性结果都应始终使用经过验证的确认检测（如核酸检测）进行复检，以区分假阳性和真阳性结果。
