Xi Chao-Yun, Ma Chun-Ya, Zhang Hong-Fei, Wei Chao, Wang De-Qing
Department of Blood Transfusion, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
Department of Blood Transfusion, Beijing Electrical Hospital Affiliated to Capital Medical University, Beijing 100073, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Oct;29(5):1662-1666. doi: 10.19746/j.cnki.issn.1009-2137.2021.05.047.
Allergic transfusion reaction (ATR) caused by plasma transfusion is one of the main adverse transfusion reactions, and severe allergic reactions may even endanger the patient's life. Currently, ATR is mainly prevented and controlled by drug prevention and symptomatic treatment, and there still lack of preventive measures such as in vitro experiments. It has been shown that mast cells and basophils are the main effector cells of allergic reactions, and histamine is one of the main mediators of IgE-mediated allergic reactions. Some experiments can be used to identify patients with allergies or plasma components containing allergens, such as detection of serum-specific IgE, IgA, anti-IgA antibody, tryptase and histamine, mast cell degranulation test, basophil activation test, and so on. The basophil activation test can also be used for functional matching of plasma in vitro. Research of in vitro experiment of ATR is good for directing the precise infusion of plasma, reducing waste of resources, and avoiding the risk of blood transfusion. As a pre-transfusion laboratory test for clinical use, in vitro experiment of functional matching provides a new way to prevent ATR.
由输血引起的过敏性输血反应（ATR）是主要的输血不良反应之一，严重的过敏反应甚至可能危及患者生命。目前，ATR主要通过药物预防和对症治疗来预防和控制，仍然缺乏体外实验等预防措施。研究表明，肥大细胞和嗜碱性粒细胞是过敏反应的主要效应细胞，组胺是IgE介导的过敏反应的主要介质之一。一些实验可用于识别过敏患者或含有过敏原的血浆成分，如检测血清特异性IgE、IgA、抗IgA抗体、类胰蛋白酶和组胺、肥大细胞脱颗粒试验、嗜碱性粒细胞活化试验等。嗜碱性粒细胞活化试验也可用于体外血浆功能匹配。ATR体外实验的研究有利于指导血浆精准输注，减少资源浪费，避免输血风险。作为临床使用的输血前实验室检测，功能匹配体外实验为预防ATR提供了新途径。
