Saleh Rozieyati Mohamed, Zefarina Zulkafli, Che Mat Nor Fazila, Chambers Geoffrey Keith, Edinur Hisham Atan
School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia.
School of Biological Sciences, Victoria University of Wellington, Wellington New Zealand.
Int J Prev Med. 2018 May 16;9:45. doi: 10.4103/ijpvm.IJPVM_232_16. eCollection 2018.
Transfusion procedures are always complicated by potential genetic mismatching between donor and recipient. Compatibility is determined by several major antigens, such as the ABO and Rhesus blood groups. Matching for other blood groups (Kell, Kidd, Duffy, and MNS), human platelet antigens, and human leukocyte antigens (HLAs) also contributes toward the successful transfusion outcomes, especially in multitransfused or highly immunized patients. All these antigens of tissue identity are highly polymorphic and thus present great challenges for finding suitable donors for transfusion patients. The ABO blood group and HLA markers are also the determinants of transplant compatibility, and mismatched antigens will cause graft rejection or graft-versus-host disease. Thus, a single and comprehensive registry covering all of the significant transfusion and transplantation antigens is expected to become an important tool in providing an efficient service capable of delivering safe blood and quickly locating matching organs/stem cells. This review article is intended as an accessible guide for physicians who care for transfusion-dependent patients. In particular, it serves to introduce the new molecular screening methods together with the biology of these systems, which underlies the tests.
输血程序总是因供体和受体之间潜在的基因不匹配而变得复杂。相容性由几种主要抗原决定,如ABO和恒河猴血型。对其他血型(凯尔、基德、达菲和MNS)、人类血小板抗原和人类白细胞抗原(HLA)进行匹配也有助于输血成功,尤其是在多次输血或高度免疫的患者中。所有这些组织身份抗原都具有高度多态性,因此为输血患者寻找合适的供体带来了巨大挑战。ABO血型和HLA标记也是移植相容性的决定因素,不匹配的抗原会导致移植排斥或移植物抗宿主病。因此,一个涵盖所有重要输血和移植抗原的单一综合登记系统有望成为提供高效服务的重要工具,该服务能够提供安全血液并快速找到匹配的器官/干细胞。这篇综述文章旨在为照顾依赖输血患者的医生提供一份易于理解的指南。特别是,它旨在介绍新的分子筛查方法以及这些系统的生物学原理,这些生物学原理是检测的基础。