Yang C-A, Lin J-A, Chang C-W, Wu K-H, Yeh S-P, Ho C-M, Chang J-G
Department of Laboratory Medicine, China Medical University Hospital, Taiwan, China.
College of Medicine, China Medical University, Taiwan, China.
Transfus Med. 2016 Oct;26(5):349-354. doi: 10.1111/tme.12357. Epub 2016 Sep 15.
To evaluate the clinical significance of GP. Mur antigen-negative blood selection for transfusion in patients with anti-'Mi ' records.
The GP. Mur RBC phenotype is prevalent (7·3%) in Taiwan. Antibodies against GP. Mur (anti-'Mi ') are identified in 1·24% of our population, and anti-'Mi ' screening using GP. Mur RBC has been routine for Taiwan's blood banks. However, due to the lack of commercial antibodies, only cross-matching was used to prevent transfusion of GP. Mur-positive blood to patients with anti-'Mi ' in most hospitals. There is still a risk of GP. Mur-positive RBC exposure and subsequent anti-'Mi '-related transfusion reactions.
Since February 2014, GP. Mur antigen-negative RBCs identified by reaction with anti-'Mi '-positive serum were selected for blood recipients with anti-'Mi ' records. The transfusion reactions between January 2013 and January 2014 were compared with those that occurred between February 2014 and July 2015.
The transfusion reaction rate was significantly higher in anti-'Mi '-positive blood recipients compared to total subjects receiving an RBC transfusion before GP. Mur-negative donor RBC selection. After antigen-negative RBC selection, the transfusion reaction frequency in subjects with anti-'Mi ' became similar to total blood recipients. IgG form anti-'Mi ' antibodies were present in all cases of probable anti-'Mi '-related transfusion reactions. The time required for anti-'Mi ' boosting after transfusion was around 4-21 days.
Selection of GP. Mur-negative RBC for transfusion to patients with anti-'Mi ' records could decrease the rate of transfusion reaction and antibody boosting. This procedure should be incorporated into blood bank routines in areas where anti-'Mi ' is prevalent.
评估针对有抗“Mi”记录的患者进行输注时选择Gp.Mur抗原阴性血液的临床意义。
Gp.Mur红细胞表型在台湾较为常见（7.3%）。在我们的人群中，抗Gp.Mur（抗“Mi”）抗体的识别率为1.24%，台湾血库常规使用Gp.Mur红细胞进行抗“Mi”筛查。然而，由于缺乏商用抗体，大多数医院仅采用交叉配血来防止向有抗“Mi”的患者输注Gp.Mur阳性血液。仍存在Gp.Mur阳性红细胞暴露以及随后发生抗“Mi”相关输血反应的风险。
自2014年2月起，通过与抗“Mi”阳性血清反应鉴定出的Gp.Mur抗原阴性红细胞被选用于有抗“Mi”记录的输血受者。将2013年1月至2014年1月期间的输血反应与2014年2月至2015年7月期间发生的输血反应进行比较。
与在选择Gp.Mur阴性供者红细胞之前接受红细胞输注的所有受试者相比，抗“Mi”阳性输血受者的输血反应率显著更高。在选择抗原阴性红细胞后，有抗“Mi”的受试者的输血反应频率变得与所有输血受者相似。在所有可能的抗“Mi”相关输血反应病例中均存在IgG形式的抗“Mi”抗体。输血后抗“Mi”增强所需时间约为4 - 21天。
选择Gp.Mur阴性红细胞输注给有抗“Mi”记录的患者可降低输血反应率和抗体增强。在抗“Mi”流行的地区，该程序应纳入血库常规操作。
