Department of Transfusion Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
Indian J Med Res. 2020 Sep;152(3):280-284. doi: 10.4103/ijmr.IJMR_296_19.
BACKGROUND & OBJECTIVES: Blood transfusion therapy involves multiple steps to ensure selection of safe blood component for transfusion. This includes testing for infectious markers, full ABO compatibility, free from any clinically significant red cell antibodies and acceptable donor's red cell survival rates without destruction of recipient's red cells. The red cell antibodies present in healthy blood donors can cause severe haemolytic transfusion reaction, especially in massive blood transfusion recipients and paediatric patients. Hence, screening of red cell antibodies in donor blood is important to provide compatible blood products and to avoid haemolytic transfusion reactions in susceptible patient population. This study was planned to assess prevalence, aetiology and type of unexpected red cell antibodies in a large number of whole blood donor population in north India.
This three-year prospective observational study included blood donor samples for antibody screening from January 2015 to December 2017. A total of 166,803 healthy blood donors including 156,128 (93.6%) males and 10,675 (6.4%) females were screened.
The prevalence of red cell antibodies was 0.17 per cent in our donor population. Of the total 286 donors with red cell antibodies, 248 (86.7%) had alloantibodies, 30 (10.5%) had autoantibodies and eight donors (2.8%) showed positive antibody screening with inconclusive results.
INTERPRETATION & CONCLUSIONS: Alloimmunization to red cell antigens is a challenging task for current transfusion practices. The antibody screening in blood donors may improve the quality and safety of blood transfusion in the recipients. It also reduces the risk of complications from incompatible blood transfusions.
输血治疗涉及多个步骤,以确保选择安全的血液成分进行输血。这包括检测感染标志物、完全 ABO 相容性、无任何临床显著的红细胞抗体以及可接受的供体红细胞存活率,而不会破坏受者的红细胞。健康献血者体内存在的红细胞抗体可导致严重的溶血性输血反应,尤其是在大量输血受者和儿科患者中。因此,筛查献血者血液中的红细胞抗体对于提供相容的血液制品和避免易感性患者群体发生溶血性输血反应非常重要。本研究旨在评估印度北部大量全血献血者人群中意外红细胞抗体的流行率、病因和类型。
这是一项为期三年的前瞻性观察性研究,包括 2015 年 1 月至 2017 年 12 月用于抗体筛查的献血者样本。共筛查了 166803 名健康献血者,其中 156128 名(93.6%)为男性,10675 名(6.4%)为女性。
在我们的献血者人群中,红细胞抗体的流行率为 0.17%。在总共 286 名有红细胞抗体的献血者中,248 名(86.7%)有同种异体抗体,30 名(10.5%)有自身抗体,8 名(2.8%)抗体筛查阳性但结果不确定。
针对红细胞抗原的同种免疫是当前输血实践面临的一项挑战。献血者的抗体筛查可提高受者输血的质量和安全性,并降低因不相容输血引起的并发症风险。