Wang Yuan-Jie, Liu Jia-Rui, Liu Yong
Blood Transfusion Department, Suining Central Hospital, An Affiliated Hospital of Chongqing University.
Clinical Laboratory, Suining Central Hospital, An Affiliated Hospital of Chongqing University.
Medicine (Baltimore). 2019 Aug;98(35):e16703. doi: 10.1097/MD.0000000000016703.
Although the electronic cross-matching of blood has been widely applied in some developed countries and regions, concern over the risk of undetected red blood cell (RBC) antibodies has limited its application in mainland China.This study was performed to explore the missed detection rate of RBC antibodies in a Chinese population from 2011 to 2016. If the results of 2 consecutive tests of ABO/RhD blood group identification were consistent and antibody screening results were negative, electronic cross-matching of the blood was performed. In addition, traditional serological cross-matching of blood (polybrene method) and a parallel experiment for electronic cross-matching of blood were performed to analyze the missed detection of unexpected RBC antibodies in blood donors and recipients.Using the polybrene method, 40,228 blood samples were tested by parallel traditional serological cross-matching of blood; among these samples, blood compatibility was found in 40,222 cases, primary incompatibility (incompatibility of the donor's erythrocytes with the recipient's serum) was found in 6 cases, and no secondary incompatibility was found. Identification of antibody specificity was performed using panel cells, and all unexpected RBC antibodies were confirmed as anti-Mur alloantibodies in the MNS system.Further improvements in the erythrocyte antigenic spectrum, especially the Mur antigen in Asian populations, are expected to ensure the safety of implementing electronic cross-matching in China.
尽管血液电子交叉配血在一些发达国家和地区已得到广泛应用，但由于担心未检测到的红细胞（RBC）抗体风险，其在中国大陆的应用受到限制。本研究旨在探讨2011年至2016年中国人群中RBC抗体的漏检率。如果连续2次ABO/RhD血型鉴定结果一致且抗体筛查结果为阴性，则进行血液电子交叉配血。此外，还进行了传统的血液血清学交叉配血（凝聚胺法）以及血液电子交叉配血的平行实验，以分析献血者和受血者中意外RBC抗体的漏检情况。采用凝聚胺法，对40228份血液样本进行了传统血清学交叉配血平行检测；其中，40222例样本血液相容，6例发现主要不相容（献血者红细胞与受血者血清不相容），未发现次要不相容。使用谱细胞鉴定抗体特异性，所有意外RBC抗体均被确认为MNS系统中的抗Mur同种抗体。预计进一步完善红细胞抗原谱，尤其是亚洲人群中的Mur抗原，将确保在中国实施电子交叉配血的安全性。
