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人类血小板抗原与发热性非溶血性输血反应有关。

Human platelet antigens are associated with febrile non-hemolytic transfusion reactions.

机构信息

Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan.

Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.

出版信息

Clin Chim Acta. 2017 Nov;474:120-123. doi: 10.1016/j.cca.2017.09.010. Epub 2017 Sep 14.

DOI:10.1016/j.cca.2017.09.010

PMID:28919492

Abstract

BACKGROUND

Febrile non-hemolytic transfusion reaction (FNHTR) is the most common type of transfusion reactions, and it could be reduced by transfusing patients with leukocyte-poor blood products. However, FNHTR still occur in certain patients transfused with leukocyte-poor red blood cell (LPR) products. It is examined whether human platelet antigen (HPA) could be a potential membrane antigen that plays a role in FNHTR.

METHODS

A total of 120 inpatient subjects who transfused with LPR (60 in FNHTR group, 60 in control group) were typed for HPA-2, HPA-3, and HPA-15 using sequence specific primer-polymerase chain reaction (SSP-PCR) and electrophoresis.

RESULTS

HPA-2 unmatched rate between donors and patients in FNHTR group was 18%, and only 3% unmatched rate was observed in control group (p=0.0082). FNHTR group was further classified according to the imputability. There was a significant difference (p=0.0041) between FNHTR (probable imputability, infection) group and control group, and more significant difference (p=0.0008) was seen between FNHTR (probable imputability, febrile neutropenia) group and control group.

CONCLUSIONS

Those results indicated that HPA-2 might play roles on inducing FNHTR in patients suffering from infectious diseases and febrile neutropenia. HPA-2 genotyping between donors and recipients might be worth integrating in pre-transfusion testing to increase transfusion safety.

摘要

背景

发热非溶血性输血反应（FNHTR）是最常见的输血反应类型，可以通过输注白细胞减少的血液制品来减少。然而，某些输注白细胞减少的红细胞（LPR）产品的患者仍会发生 FNHTR。研究人员检查了人类血小板抗原（HPA）是否可以作为膜抗原在 FNHTR 中发挥作用。

方法

采用序列特异性引物-聚合酶链反应（SSP-PCR）和电泳法对 120 例输注 LPR 的住院患者（FNHTR 组 60 例，对照组 60 例）进行 HPA-2、HPA-3 和 HPA-15 分型。

结果

FNHTR 组供者与患者之间 HPA-2 不匹配率为 18%，而对照组仅为 3%（p=0.0082）。根据归因可能性将 FNHTR 组进一步分类。FNHTR（可能归因于感染）组与对照组之间存在显著差异（p=0.0041），FNHTR（可能归因于发热性中性粒细胞减少症）组与对照组之间存在更显著差异（p=0.0008）。