Erikstein B S, Hagen K G, Hervig T
Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Science, University of Bergen, Bergen, Norway.
Transfus Med. 2019 Jun;29(3):169-178. doi: 10.1111/tme.12511. Epub 2018 Jan 29.
Although several studies focus on red blood cell (RBC) alloantibody distribution in selected patient populations, few address the specificity and frequency in all relevant groups. This study reports alloantibody frequency, distribution and the relationship to age and gender in blood donors, pregnant women and potential recipients of blood products.
This historical cohort study included 55 462 consecutive antibody screening tests from a tertiary Western Norwegian Hospital. Descriptive statistics were performed, and the results were compared with the literature.
The detection and immunisation frequency for the whole cohort were 0·39 and 0·51%, respectively, whereas the RBC alloantibody prevalence was 0·73%. The most frequent RBC alloantibodies were anti-E (20·1%), anti-M (18·7%), anti-K (9·8%), anti-D (8·9%) and anti-Fy(a) (7·0%). In pregnant women, the most frequent RBC alloantibodies were anti-M, anti-D and anti-Le(a) (20·8, 18·9 and 18·9%, respectively), whereas there was no anti-K detected. Anti-E and anti-M were the dominating RBC alloantibodies in the pre-transfusion testing of in-hospital patients (24·1 and 17·1%, respectively). Eighteen (9·2%) persons in the total cohort had two RBC alloantibodies, six persons had three alloantibodies, and two persons had four alloantibodies. Rh and K typing to prevent future immunisations was only performed in 21·0% of the individuals who presented with a new alloantibody; despite that, 50·5% of the detected alloantibodies had such specificities.
The immunisation frequency and the level of anti-K are low compared to national and international studies. Rh and K phenotype-matched blood transfusions might be a feasible future strategy to further decrease RBC alloantibodies.
尽管有多项研究聚焦于特定患者群体中的红细胞（RBC）同种抗体分布情况，但很少有研究涉及所有相关群体中的特异性和频率。本研究报告了献血者、孕妇及血液制品潜在受者中同种抗体的频率、分布及其与年龄和性别的关系。
这项历史性队列研究纳入了挪威西部一家三级医院连续进行的55462次抗体筛查检测。进行了描述性统计，并将结果与文献进行了比较。
整个队列的检测频率和免疫频率分别为0.39%和0.51%，而RBC同种抗体患病率为0.73%。最常见的RBC同种抗体为抗-E（20.1%）、抗-M（18.7%）、抗-K（9.8%）、抗-D（8.9%）和抗-Fy(a)（7.0%）。在孕妇中，最常见的RBC同种抗体为抗-M、抗-D和抗-Le(a)（分别为20.8%、18.9%和18.9%），而未检测到抗-K。抗-E和抗-M是住院患者输血前检测中占主导地位的RBC同种抗体（分别为24.1%和17.1%）。整个队列中有18人（9.2%）有两种RBC同种抗体，6人有三种同种抗体，2人有四种同种抗体。在出现新的同种抗体的个体中，仅21.0%的人进行了Rh和K分型以预防未来免疫；尽管如此，检测到的同种抗体中有50.5%具有此类特异性。
与国内和国际研究相比，免疫频率和抗-K水平较低。Rh和K表型匹配的输血可能是未来进一步降低RBC同种抗体的可行策略。
