Chonat Satheesh, Arthur Connie M, Zerra Patricia E, Maier Cheryl L, Jajosky Ryan P, Yee Marianne E M, Miller Maureen J, Josephson Cassandra D, Roback John D, Fasano Ross, Stowell Sean R
Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, 101, Woodruff Circle, 30322 Atlanta, GA, USA.
Transfus Clin Biol. 2019 May;26(2):130-134. doi: 10.1016/j.tracli.2019.03.002. Epub 2019 Mar 25.
Red blood cell (RBC) transfusion support represents a critical component of sickle cell disease (SCD) management. However, as with any therapeutic intervention, RBC transfusion is not without risk. Repeat exposure to allogeneic RBCs can result in the development of RBC alloantibodies that can make it difficult to find compatible RBCs for future transfusions and can directly increase the risk of developing acute or delayed hemolytic transfusion reactions, which can be further complicated by hyperhemolysis. Several prophylactic and treatment strategies have been employed in an effort to reduce or prevent hemolytic transfusion reactions. However, conflicting data exist regarding the efficacy of many of these approaches. We will explore the challenges associated with predicting, preventing and treating different types of hemolytic transfusion reactions in patients with SCD in addition to describing future strategies that may aid in the management of the complex transfusion requirements of SCD patients.
红细胞（RBC）输血支持是镰状细胞病（SCD）管理的关键组成部分。然而，与任何治疗干预一样，RBC输血并非没有风险。反复接触异体RBC可导致RBC同种抗体的产生，这可能会使未来输血时难以找到相容的RBC，并可能直接增加发生急性或迟发性溶血性输血反应的风险，而高溶血可能会使这些反应进一步复杂化。为了减少或预防溶血性输血反应，已经采用了几种预防和治疗策略。然而，关于其中许多方法的疗效存在相互矛盾的数据。除了描述可能有助于管理SCD患者复杂输血需求的未来策略外，我们还将探讨预测、预防和治疗SCD患者不同类型溶血性输血反应所面临的挑战。
