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为有抗“Mi”记录的输血受者选择缺乏Mur抗原的红细胞可降低台湾地区的输血反应率。

Selection of GP. Mur antigen-negative RBC for blood recipients with anti-'Mi ' records decreases transfusion reaction rates in Taiwan.

作者信息

Yang C-A, Lin J-A, Chang C-W, Wu K-H, Yeh S-P, Ho C-M, Chang J-G

机构信息

Department of Laboratory Medicine, China Medical University Hospital, Taiwan, China.

College of Medicine, China Medical University, Taiwan, China.

出版信息

Transfus Med. 2016 Oct;26(5):349-354. doi: 10.1111/tme.12357. Epub 2016 Sep 15.

Abstract

OBJECTIVES

To evaluate the clinical significance of GP. Mur antigen-negative blood selection for transfusion in patients with anti-'Mi ' records.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

背景

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。

方法

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。

结果

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。

结论

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。

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