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红细胞储存对同种免疫的影响。

Effect of storage of red blood cells on alloimmunization.

机构信息

Center for Clinical Transfusion Research, Sanquin Blood Supply, Leiden, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Jon J. van Rood Center for Clinical Transfusion Research, Leiden University Medical Center, Leiden, The Netherlands; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands; Blood Transfusion, Pediatric and Point of Care, Clinical Chemistry and Hematology Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands; Puget Sound Blood Center Research Institute, Seattle, Washington.

出版信息

Transfusion. 2013 Nov;53(11):2795-800. doi: 10.1111/trf.12156. Epub 2013 Mar 11.

Abstract

BACKGROUND

Red blood cells (RBCs) undergo changes during storage. Various studies have suggested a higher risk of adverse and often multifactorial clinical outcomes associated with older-stored RBCs. Our aim therefore was to examine if storage of transfused RBCs is also associated with the risk of RBC-specific alloantibody formation.

STUDY DESIGN AND METHODS

A two-center retrospective case-referent study was performed where case patients and control subjects were sampled from all consecutive patients who had received their first and subsequent RBC transfusions in one of the two centers only. Cases were defined as patients who developed a first RBC alloantibody. Control subjects were patients without detectable RBC alloantibodies, who were matched to the case patients regarding number of RBC transfusions. Binary logistic regression analysis was used to examine the association between storage time of RBCS and the occurrence of alloimmunization.

RESULTS

A total of 144 cases and 286 controls were selected for our study, who had received a total 5478 RBC units. Comparing patients receiving units stored shorter than a certain number of days versus older units (with various storage periods up to 4 weeks) did not reveal an association or a trend between alloimmunization risk and storage time categories.

CONCLUSION

Our findings suggest that storage times of transfused RBCs between 1 and 4 weeks do not affect the risk of alloimmunization.

摘要

背景

红细胞(RBC)在储存过程中会发生变化。多项研究表明,与陈旧储存 RBC 相关的不良临床结局风险更高,且往往是多因素的。因此,我们的目的是研究输注的 RBC 储存时间是否也与 RBC 特异性同种异体抗体形成的风险相关。

研究设计和方法

进行了一项两中心回顾性病例对照研究,从两个中心中仅接受了第一次和随后的 RBC 输血的所有连续患者中抽取病例患者和对照受试者。病例定义为首次发生 RBC 同种异体抗体的患者。对照受试者为未检测到 RBC 同种异体抗体的患者,他们与病例患者在 RBC 输注次数方面相匹配。采用二项逻辑回归分析来研究 RBC 储存时间与发生同种免疫之间的关联。

结果

我们的研究共选择了 144 例病例和 286 例对照,共接受了 5478 个 RBC 单位。比较接受储存时间较短的单位(少于一定天数)与较陈旧单位(储存时间长达 4 周)的患者,未发现同种免疫风险与储存时间类别之间存在关联或趋势。

结论

我们的研究结果表明,1 至 4 周的输注 RBC 储存时间不会影响同种免疫的风险。

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