Handa Anjali, Kukar Neetu, Maharishi Ram N, Syal Neha, Arora Harkiran
Department of Immunohematology and Transfusion Medicine, SMS Medical College and Hospital, Jaipur, Rajasthan, India.
Department of Immunohematology and Blood Transfusion, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
J Family Med Prim Care. 2020 Jun 30;9(6):2907-2911. doi: 10.4103/jfmpc.jfmpc_351_20. eCollection 2020 Jun.
Red blood cell (RBC) alloimmunization is an immune response against foreign RBC antigens; this generally occurs after sensitization due to multiple blood transfusions and pregnancies. Antibody detection plays a critical role in transfusion medicine as it can detect irregular or unexpected antibodies. This study was done to know the frequency and specificity of unexpected red cell antibodies in the multitransfused patients.
This prospective study was done in the Department of Immuno-Haematology and Blood Transfusion. Antibody screening of 100 multitransfused patients with initial negative antibody screen was carried out prior to compatibility testing and followed for a period of 12 months for each transfusion. Depending on the results, patients were given corresponding antigen-negative blood units.
In this study, the rate of alloimmunization was 7%. Total number of samples that were positive for irregular alloantibodies were 4 of 54 cases of thalassemia, that is, 7.4%, whereas 3 of 40, that is, 7.5%, cases of solid malignancies developed alloantibodies. None of the patients of chronic kidney disease formed any alloantibody. Anti-K antibody was the most frequent antibody detected in 3 of 7, that is, 42.8% patients. Anti-E was the second most frequent antibody observed in 2 of 7, that is, 28.57%. However, anti-c and anti-M were detected in one each of 7, that is, in 14.28% each.
It is concluded here that red cell alloimmunization should not be overlooked in multitransfused patients. To avoid the effects of alloimmunization, routine RBC antibody screening at set time intervals after transfusion should be performed.
红细胞同种免疫是针对外来红细胞抗原的免疫反应；这通常发生在因多次输血和妊娠致敏之后。抗体检测在输血医学中起着关键作用，因为它可以检测出不规则或意外抗体。本研究旨在了解多次输血患者中意外红细胞抗体的频率和特异性。
本前瞻性研究在免疫血液学和输血科进行。对100例初次抗体筛查阴性的多次输血患者在进行相容性检测前进行抗体筛查，并在每次输血后随访12个月。根据结果，为患者提供相应的抗原阴性血液单位。
在本研究中，同种免疫率为7%。地中海贫血患者中54例有4例不规则同种抗体呈阳性，即7.4%，而实体恶性肿瘤患者中40例有3例，即7.5%，产生了同种抗体。慢性肾脏病患者均未形成任何同种抗体。抗-K抗体是最常检测到的抗体，7例中有3例，即42.8%。抗-E是第二常检测到的抗体，7例中有2例，即28.57%。然而，抗-c和抗-M在7例中各有1例检测到，即各占14.28%。
由此得出结论，多次输血患者不应忽视红细胞同种免疫。为避免同种免疫的影响，输血后应定期进行红细胞抗体常规筛查。
