Moeen Shazia, Farooq Nazish, Irshad Romana, Ashfaq Muhammad, Farooq Umer, Idris Muhammad
Department of Pathology.
Department of Community Medicine, Ayub Medical College, Abbottabad, Pakistan.
J Ayub Med Coll Abbottabad. 2018 Jan-Mar;30(1):81-84.
Lifelong transfusions are life savers for thalassaemia patients but are associated with many complications. Alloimmunization is a major problem for blood banks. Antigens of foreign red blood cells induce the formation of antibodies in patients suffering from thalassaemia. The purpose of this study was to examine the frequency of red cell alloantibodies and to express the type of these antibodies in thalassaemia patients.
Patients that have received multiple transfusions were included in this study. Those with the positive Coombs test (DAT) results were excluded from the study and remaining patients were screened for antibodies. A panel of known blood group antigens was used for the patients who had a positive antibody screening test because they had alloantibodies in their serum. First, three cell panel was applied. If the screen was positive then eleven cell panels was used to identify the specific antibody. Both the cell panels were applied at room-temperature, liss (low ionic strength saline) and coombs phase.
Three hundred & two patients were selected out of which 65.6% (n=198) were males and 34.4% (n=104) females. Patient's age ranged from 1.5 years to 26 years ±5.40 years. All of the patients were given regular red cell transfusion at 2-4 weeks interval. They were given non leukodepleted transfusions. It is not the practice in any thalassaemia Centre in Pakistan to give phenotypically matched blood for Kell, Kidd, Duffy or any other minor group antigens to patients on regular blood transfusion. Alloimmunization was positive in 12 (4.0%) of the 302 patients studied. Male were 66.67% (n=8) and female were 33.33% (n=4). Samples of these positive patients were further tested to determine specificity of alloantibodies. Anti Cw was most common, detected in 4 out of 12 (1.3%) patients. Anti K, k, S and Lua were detected in 2 out of 12 (0.7%) each.
Thalassemia major patients on regular blood transfusions can develop red cell alloantibodies. Detailed pretransfusion screening would add towards better management of these patients.
终身输血是地中海贫血患者的救命方法，但会引发许多并发症。同种免疫是血库面临的一个主要问题。外来红细胞抗原会在患有地中海贫血的患者体内诱导抗体形成。本研究的目的是检测红细胞同种抗体的频率，并明确这些抗体在 地中海贫血患者中的类型。
本研究纳入接受过多次输血的患者。库姆斯试验（直接抗人球蛋白试验）结果呈阳性的患者被排除在研究之外，其余患者进行抗体筛查。对于血清中存在同种抗体因而抗体筛查试验呈阳性的患者，使用一组已知血型抗原进行检测。首先，应用三张细胞玻片。如果筛查呈阳性，则使用十一张细胞玻片来鉴定特异性抗体。两张细胞玻片均在室温、低离子强度盐水（LISS）和抗人球蛋白相下应用。
共选取 302 例患者，其中男性占 65.6%（n = 198），女性占 34.4%（n = 104）。患者年龄范围为 1.5 岁至 26 岁，平均年龄为 26 岁±5.40 岁。所有患者均每隔 2 - 4 周接受一次常规红细胞输血。所输血液均未经过白细胞滤除处理。在巴基斯坦的任何地中海贫血治疗中心，对于接受常规输血的患者，都不会提供针对凯尔、基德、达菲或任何其他次要血型抗原的表型匹配血液。在 302 例研究患者中，12 例（4.0%）同种免疫呈阳性。男性占 66.67%（n = 8），女性占 33.33%（n = 4）。对这些阳性患者的样本进一步检测以确定同种抗体的特异性。抗 Cw最为常见，在 12 例患者中有 4 例（1.
