Williams R A, Brown E F, Hurst D, Franklin L C
Department of Pathology, Children's Hospital, Oakland, CA 94609.
J Pediatr. 1989 Dec;115(6):949-53. doi: 10.1016/s0022-3476(89)80748-6.
A protocol for transfusion of infants with erythrocyte T-antigen activation was evaluated for safety and effectiveness in a prospective, 3-year, sequential series of 1672 infants admitted for intensive care. Erythrocyte T antigens are activated by enzymes produced by clostridia or other bacteria in infants with sepsis, often in association with necrotizing enterocolitis. Transfusion of these infants with blood products containing plasma carries the risk of causing intravascular hemolysis. Our transfusion protocol included testing for T-antigen activation, restricting transfusion of patients with activated T antigens to washed erythrocytes or washed platelets whenever possible, and selecting donors with low-titer anti-T when plasma-containing blood products were required. In this series, 10 patients had T-antigen activation, including four with clostridial infections. Severe hemolysis occurred in one patient who received plasma before T-antigen activation developed. Of five patients who received low-titer anti-T plasma, mild hemolysis occurred in three and no hemolysis in two. Four patients who received no plasma-containing blood products experienced no hemolysis. Used cautiously, this protocol allows a full range of transfusion therapy to infants with T-antigen activation.
一项针对红细胞T抗原激活的婴儿输血方案，在一项为期3年的前瞻性连续研究中，对1672名入住重症监护病房的婴儿进行了安全性和有效性评估。在患有败血症的婴儿中，红细胞T抗原会被梭状芽孢杆菌或其他细菌产生的酶激活，通常与坏死性小肠结肠炎有关。给这些婴儿输注含有血浆的血液制品有导致血管内溶血的风险。我们的输血方案包括检测T抗原激活情况，尽可能将T抗原激活的患者的输血限制为洗涤红细胞或洗涤血小板，以及在需要含血浆的血液制品时选择抗T效价低的献血者。在这个系列中，有10名患者出现T抗原激活，其中4名患有梭菌感染。1名在T抗原激活出现前接受血浆的患者发生了严重溶血。在5名接受低效价抗T血浆的患者中，3名发生了轻度溶血，2名未发生溶血。4名未接受含血浆血液制品的患者未发生溶血。谨慎使用该方案可为T抗原激活的婴儿提供全面的输血治疗。
