Enko Dietmar, Habres Claudia, Wallner Franz, Mayr Barbara, Halwachs-Baumann Gabriele
Department of Laboratory Medicine, Central Hospital Steyr, Sierningerstraße 170, 4400 Steyr, Austria.
University of Applied Sciences for Health Professions Upper Austria, Bachelor Program Biomedical Science, Central Hospital Steyr, Sierningerstraße 170, 4400 Steyr, Austria.
J Blood Transfus. 2014;2014:532919. doi: 10.1155/2014/532919. Epub 2014 Mar 25.
The aim of this study was to determine the frequencies and specificities of "enzyme-only" detected red blood cell (RBC) alloantibodies in the routine antibody screening and antibody identification in patients hospitalized in Austria. Routine blood samples of 2420 patients were investigated. The antibody screening was performed with a 3-cell panel in the low-ionic strength saline- (LISS-) indirect antiglobulin test (IAT) and with an enzyme-pretreated (papain) 3-cell panel fully automated on the ORTHO AutoVue Innova System. The antibody identification was carried out manually with an 11-cell panel in the LISS-IAT and with an enzyme-pretreated (papain) 11-cell panel. In total 4.05% (n = 98) of all patients (n = 2420) had a positive RBC antibody screening result. Of them 25.51% (25/98) showed "enzyme-only" detected specific or nonspecific RBC alloantibodies. Rhesus and Lewis system antibodies were found the only specificities of "enzyme-only" RBC alloantibodies: all in all 4.8% (4/98) were detected with anti-E, 3.06% (3/98) with anti-Le(a), 3.06% (3/98) with anti-D after anti-D prophylaxis and 1.02% (1/98) with anti-e. In total, 14.29% (14/98) showed a nonspecific RBC alloantibody result with the enzyme test. The results of the present study demonstrate that a high number of unwanted positive reactions with the enzyme technique overshadows the detection of "enzyme-only" RBC alloantibodies. (
K-37-13).
本研究的目的是确定在奥地利住院患者的常规抗体筛查和抗体鉴定中，“仅酶法检测到的”红细胞（RBC）同种抗体的频率和特异性。对2420例患者的常规血样进行了研究。抗体筛查在低离子强度盐水（LISS）间接抗球蛋白试验（IAT）中使用3细胞面板进行，并在ORTHO AutoVue Innova系统上全自动进行酶预处理（木瓜蛋白酶）3细胞面板检测。抗体鉴定在LISS-IAT中使用11细胞面板手动进行，并使用酶预处理（木瓜蛋白酶）11细胞面板。所有患者（n = 2420）中共有4.05%（n = 98）的红细胞抗体筛查结果呈阳性。其中25.51%（25/98）显示“仅酶法检测到的”特异性或非特异性红细胞同种抗体。发现恒河猴和刘易斯系统抗体是“仅酶法检测到的”红细胞同种抗体的唯一特异性：总体而言，4.8%（4/98）的抗-E抗体被检测到，3.06%（3/98）的抗-Le(a)抗体被检测到，抗-D预防后3.06%（3/98）的抗-D抗体被检测到，1.02%（1/98）的抗-e抗体被检测到。总共14.29%（14/98）的酶试验显示非特异性红细胞同种抗体结果。本研究结果表明，酶技术产生的大量不必要的阳性反应掩盖了“仅酶法检测到的”红细胞同种抗体的检测。（试验注册号：K-37-13）
