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尼日利亚南南地区哈科特港慢性肾病多次输血患者的红细胞同种免疫

Red blood cell alloimmunization in multi-transfused patients with chronic kidney disease in Port Harcourt, South-South Nigeria.

作者信息

Obi Esther Ifeoma, Pughikumo Crosdale Ogho, Oko-Jaja Richard Ishmael

机构信息

Department of Haematology and Blood Transfusion, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.

Department of Haematology and Immunology, College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.

出版信息

Afr Health Sci. 2018 Dec;18(4):979-987. doi: 10.4314/ahs.v18i4.18.

Abstract

BACKGROUND

Serological safety is an integral part of overall safety for blood banks.

OBJECTIVES

The aim of the study was to determine the prevalence and specificities of red blood cell alloimmunization in multi-transfused patients with chronic kidney disease (CKD).

METHODS

A cross-sectional case-control study carried out at the University of Port Harcourt Teaching Hospital in which 186 patients with CKD were enrolled consecutively, 124 had received multiple transfusions (more than one unit of blood in one month, or at least 10 units within 3 months), while 62 had never been transfused. Antibody screen test was performed by the gel agglutination technique. RBC antibody identification was performed on the sera of those that tested positive to antibody screening test.

RESULTS

Out of the 124 multi-transfused patients (total of 789 transfusions), 4 (3.2%) were alloimmunised. The alloimmunised patients received a higher mean number of 17.5 ± 12 blood units, compared to 6 ± 6 units by the non-alloimmunised multi-transfused patient (p= <0.001). Six clinically significant alloantibodies were identified with all of the alloimmunised patients forming more than one antibody. Anti-E was detected in all alloimmunised patients.

CONCLUSION

The prevalence of RBC alloimmunisation in multi-transfused CKD patients was 3.2% with anti-E being the most frequently identified antibody.

摘要

背景

血清学安全性是血库整体安全性的一个组成部分。

目的

本研究的目的是确定慢性肾脏病(CKD)多次输血患者中红细胞同种免疫的患病率和特异性。

方法

在哈科特港大学教学医院进行了一项横断面病例对照研究,连续纳入186例CKD患者,其中124例接受过多次输血(一个月内输血超过1单位,或3个月内至少输血10单位),而62例从未输血。采用凝胶凝集技术进行抗体筛查试验。对抗体筛查试验呈阳性的患者血清进行红细胞抗体鉴定。

结果

在124例多次输血患者(共输血789次)中,4例(3.2%)发生了同种免疫。与未发生同种免疫的多次输血患者平均接受6±6单位血液相比,发生同种免疫的患者平均接受17.5±12单位血液(p =<0.001)。鉴定出6种具有临床意义的同种抗体,所有发生同种免疫的患者均形成了不止一种抗体。所有发生同种免疫的患者均检测到抗-E。

结论

多次输血的CKD患者中红细胞同种免疫的患病率为3.2%,抗-E是最常鉴定出的抗体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5dd/6354886/32f93aa06213/AFHS1804-0979Fig1.jpg

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