Duboeuf S, Flourié F, Courbil R, Benamara A, Rigal E, Cognasse F, Garraud O
Établissement français du sang Auvergne-Loire, Saint-Étienne, France.
Transfus Clin Biol. 2012 Dec;19(6):358-65. doi: 10.1016/j.tracli.2012.10.002. Epub 2012 Nov 14.
Some alloantibodies and their combinations can lead to delays or even an impasse in a transfusion, owing to the necessity of finding compatible red blood cell concentrates. The aim of this study was to determine the specificities of the most common alloantibodies, as well as the most common combinations of alloantibodies.
A retrospective study analysed erythrocyte alloantibodies identified in 2008 in the immunohematology laboratories at the Auvergne-Loire French Blood Establishment. The following data were studied: frequency, specificities of the alloantibodies, date of discovery, and patient age and sex.
One thousand eight hundred and fifteen alloantibodies were identified in 1575 patients (median age: 63.5years, female/male ratio: 3.03). The most common alloantibodies were directed against the following antigens: RH3/E (18.7%), KEL1/K (17.3%), RH1/D (16.4%), MNS1/M (9.4%), FY1/Fya (6.9%), RH2/C (6.1%), KEL3/Kpa (4.7%), JK1/Jka (4.3%) and RH4/c (4.1%). In 13.1% of patients, at least two alloantibodies were identified. The pairs most frequently combined were anti-RH1/RH2, anti-RH3/RH4 and anti-RH3/KEL1.
Specific associations of paired alloantibodies were identified. The main combinations provide indications on the choice of red cell concentrates in the inventory for a given patient. The data collected in our study show that when an antibody is identified, it is recommended for subsequent transfusion episodes to respect the phenotype RH 1-5 (D, C, E, c, e) and KEL1 (K) of the patient, and if possible antigens JK1 (Jka) and FY1 (Fya), and to a lesser extent MNS3 (S). Detailed knowledge of the immunological mechanisms leading to the formation of these alloantibodies and their combinations would allow better prevention of erythrocyte alloimmunization.
由于需要寻找相容的红细胞浓缩物，一些同种抗体及其组合可能导致输血延迟甚至陷入僵局。本研究的目的是确定最常见的同种抗体的特异性，以及同种抗体最常见的组合。
一项回顾性研究分析了2008年在法国奥弗涅-卢瓦尔河地区血液中心免疫血液学实验室鉴定出的红细胞同种抗体。研究了以下数据：频率、同种抗体的特异性、发现日期以及患者的年龄和性别。
在1575名患者（中位年龄：63.5岁，女性/男性比例：3.03）中鉴定出1815种同种抗体。最常见的同种抗体针对以下抗原：RH3/E（18.7%）、KEL1/K（17.3%）、RH1/D（16.4%）、MNS1/M（9.4%）、FY1/Fya（6.9%）、RH2/C（6.1%）、KEL3/Kpa（4.7%）、JK1/Jka（4.3%）和RH4/c（4.1%）。在13.1%的患者中，鉴定出至少两种同种抗体。最常组合的配对是抗RH1/RH2、抗RH3/RH4和抗RH3/KEL1。
确定了配对同种抗体的特定关联。主要组合为给定患者库存中红细胞浓缩物的选择提供了指示。我们研究中收集的数据表明，当鉴定出一种抗体时，建议在随后的输血过程中考虑患者的RH 1-5（D、C、E、c、e）和KEL1（K）表型，如有可能，考虑抗原JK1（Jka）和FY1（Fya），以及程度较轻的MNS3（S）。对导致这些同种抗体及其组合形成的免疫机制的详细了解将有助于更好地预防红细胞同种免疫。
