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三级医院患者和献血者中ABO血型正反定型不符的回顾性分析。

Retrospective analysis of forward and reverse ABO typing discrepancies among patients and blood donors in a tertiary care hospital.

作者信息

Makroo R N, Kakkar B, Agrawal S, Chowdhry M, Prakash B, Karna P

机构信息

Department of Transfusion Medicine, Indraprastha Apollo Hospital, New Delhi, India.

出版信息

Transfus Med. 2019 Apr;29(2):103-109. doi: 10.1111/tme.12506. Epub 2018 Jan 12.

Abstract

OBJECTIVE

The aim of our study was to determine the incidence and causes of ABO typing discrepancies among patients and blood donors at our centre.

BACKGROUND

An accurate interpretation of the ABO blood group of an individual is of utmost importance to ensure patient safety and good transfusion practices.

METHODS

A retrospective observational study was carried out in the Department of Transfusion Medicine in our hospital from March 2013 to December 2015. Records of all patient and blood donor samples were retrieved and analysed for ABO typing discrepancies.

RESULTS

In total, 135 853 patient and 62 080 donor samples were analysed for ABO typing discrepancies. The incidence among patients and blood donors was found to be 0·1% (138/135853) and 0·02% (14/62080), respectively. The mean age for patients and blood donors was 48·4 and 29·2 years, respectively. The most common cause of ABO typing discrepancies was due to cold autoantibodies among the patients (50·7%) and blood donors (57%) causing discrepant results in reverse typing. The various other causes of reverse typing discrepancies among patients were weak/missing antibody (25·4%), cold-reacting alloantibody (4·3%), warm autoantibody (2·2%), anti-A1 antibody (2·2%), Bombay phenotype (1·5%), transplantation (0·7%) and rouleaux (0·7%), whereas in blood donors, the causes were cold-reacting antibody (7%) and weak antibody (7%). The major cause of forward typing discrepancies among patients (12·3%) and blood donors (29%) was ABO subgroups.

CONCLUSION

The resolution of ABO typing discrepancy is essential to minimise the chance of transfusion of ABO-incompatible blood.

摘要

目的

我们研究的目的是确定本中心患者和献血者中ABO血型鉴定不符的发生率及原因。

背景

准确解读个体的ABO血型对于确保患者安全及良好的输血操作至关重要。

方法

2013年3月至2015年12月在我院输血医学科开展了一项回顾性观察研究。检索并分析了所有患者和献血者样本的记录,以查找ABO血型鉴定不符情况。

结果

共分析了135853份患者样本和62080份献血者样本的ABO血型鉴定不符情况。发现患者和献血者中的发生率分别为0.1%(138/135853)和0.02%(14/62080)。患者和献血者的平均年龄分别为48.4岁和29.2岁。ABO血型鉴定不符的最常见原因是患者(50.7%)和献血者(57%)中的冷凝集素导致反向定型结果不符。患者反向定型不符的其他各种原因包括弱/无抗体(25.4%)、冷反应性同种抗体(4.3%)、温自身抗体(2.2%)、抗A1抗体(2.2%)、孟买血型(1.5%)、移植(0.7%)和缗钱状形成(0.7%),而在献血者中,原因是冷反应性抗体(7%)和弱抗体(7%)。患者(12.3%)和献血者(29%)正向定型不符的主要原因是ABO亚型。

结论

解决ABO血型鉴定不符对于将输注ABO血型不相容血液的可能性降至最低至关重要。

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