Yale University, Department of Laboratory Medicine, New Haven, Connecticut.
Department of Pathology & Laboratory Medicine Service, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
Transfusion. 2020 Apr;60(4):831-839. doi: 10.1111/trf.15718. Epub 2020 Feb 15.
Blood donors represent a healthy population, whose red blood cell (RBC) alloantibody persistence or evanescence kinetics may differ from those of immunocompromised patients. A better understanding of the biologic factors impacting antibody persistence is warranted, as the presence of alloantibodies may impact donor health and the fate of the donated blood product.
Donor/donation data collected from four US blood centers from 2012 to 2016 as part of the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) were analyzed. Clinically significant antibodies from blood donors with more than one donation who underwent at least one follow-up antibody screen after the initial antibody identification were included. Of 632,378 blood donors, 481 (128 males and 353 females) fit inclusion criteria.
Antibody screens detected 562 alloantibodies, with 368 of 562 (65%) of antibodies being persistently detected and with 194 of 562 (35%) becoming evanescent. Factors associated with antibody persistence included antibody specificity, detection at the first donation, reported history of transfusion, and detection of multiple antibodies concurrently. Anti-D, C, and Fy were most likely to persist, while anti-M, Jk , and S were most frequently evanescent.
These data provide insight into variables impacting the duration of antibody detection, and they may also influence blood donor center policies regarding donor recruitment/acceptance.
献血者代表着健康人群，其红细胞（RBC）同种异体抗体的持续存在或消失动力学可能与免疫功能低下患者不同。更好地了解影响抗体持续存在的生物学因素是必要的，因为同种异体抗体的存在可能会影响供体健康和捐赠血液产品的命运。
对 2012 年至 2016 年期间四个美国血液中心作为受体流行病学和供体评估研究-III（REDS-III）的一部分收集的供体/献血数据进行了分析。对至少在初次抗体鉴定后进行了一次以上后续抗体筛查的、有多次献血史的献血者中发现的有临床意义的抗体进行了分析。在 632,378 名献血者中，有 481 名（男性 128 名，女性 353 名）符合纳入标准。
抗体筛查检测到 562 种同种异体抗体，其中 368 种（65%）抗体持续存在，194 种（35%）抗体消失。与抗体持续存在相关的因素包括抗体特异性、初次献血时的检测、报告的输血史以及同时检测到多种抗体。抗-D、C 和 Fy 最有可能持续存在，而抗-M、Jk 和 S 则最常消失。
这些数据提供了对影响抗体检测持续时间的变量的深入了解，也可能影响血液中心有关招募/接受供体的政策。
