Assistant Professor, Department of Transfusion Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Additional Professor cum HOD, Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, India.
Immunohematology. 2020 Sep;36(3):93-98.
This scientific article emphasizes the importance of a policy for antibody screening of all blood donors as a step to further improve blood safety. We also report the incidence of red blood cell (RBC) alloimmunization in healthy blood donors obtained using a cross-sectional prospective study from September 2017 to January 2019 in the Department of Transfusion Medicine of a tertiary care referral and teaching institute in northern India. The indirect antiglobulin test (IAT) for unexpected RBC antibodies was performed by the conventional tube test with pooled group O RBCs on all donor units irrespective of their D status. Samples with positive IATs were sent to the Immune Hematology Reference Laboratory for further immunohematolo-gy workup, maintaining predefined optimal storage and transport conditions. Of the 10,390 donors studied, 9959 were males and 431 were females. The incidence of unexpected antibodies (antibodies other than those of the ABO blood system) among the blood donors was found to be 0.18 percent (19 of 10,390 with 25 alloantibodies). Of the 19 alloimmunized donors, 16 (84.2%) were male (alloimmunization rate 0.16%, 16 of 9959) and 3 (15.8%) were female (alloimmunization rate 0.69%, 3 of 431) (p = 0.01; chi-square test). In our study, the most frequent alloantibodies identified were of the Lewis blood group system (17 of 25 [68%] in 14 of the 19 alloimmunized donors). The second most common allo-antibodies belonged to the Rh blood group system (4 of 25 [16%] in 3 of the 19 alloimmunized donors), followed by those of the MNS blood group system (3 of 25 [12%] in 2 of 19 alloimmunized donors). Anti-K was found in one donor (1 of 25 [4%]). Based on the results of the study, we recommend that a policy of routinely performing IATs on all donor units, irrespective of their D status, be adopted as an essential component of safe blood transfusion practices.
本文强调了对所有献血者进行抗体筛查的政策的重要性，这是进一步提高血液安全性的一步。我们还报告了 2017 年 9 月至 2019 年 1 月在印度北部一家三级转诊和教学研究所的输血医学系进行的一项横断面前瞻性研究中，健康献血者中红细胞（RBC）同种免疫的发生率。使用常规试管试验对所有供者单位（无论其 D 状态如何）进行意外 RBC 抗体的间接抗球蛋白试验（IAT）。对 IAT 阳性的样本进行免疫血液学参考实验室的进一步免疫血液学检查，同时保持预先确定的最佳储存和运输条件。在研究的 10390 名献血者中，9959 名为男性，431 名为女性。献血者中意外抗体（除 ABO 血型系统外的抗体）的发生率为 0.18%（10390 例中有 19 例有 25 种同种抗体）。在 19 名同种免疫的献血者中，16 名（84.2%）为男性（同种免疫率为 0.16%，9959 例中有 16 例），3 名（15.8%）为女性（同种免疫率为 0.69%，431 例中有 3 例）（p=0.01；卡方检验）。在我们的研究中，鉴定出的最常见的同种抗体是 Lewis 血型系统（19 名同种免疫的献血者中的 14 名中有 17 种[68%]）。第二常见的同种抗体属于 Rh 血型系统（19 名同种免疫的献血者中的 3 名中有 4 种[16%]），其次是 MNS 血型系统（19 名同种免疫的献血者中的 2 名中有 3 种[12%]）。在一名献血者中发现抗-K（25 例中有 1 例[4%]）。根据研究结果，我们建议采用常规对所有供者单位（无论其 D 状态如何）进行 IAT 的政策，作为安全输血实践的重要组成部分。
