Powell Zachary, Jiang Nan, Shrestha Rajeshwori, Jackson Denise E
Laboratory Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia.
Blood Transfus. 2022 Mar;20(2):132-142. doi: 10.2451/2021.0421-20. Epub 2021 Mar 12.
Despite stringent testing protocols, there always remains a chance of a delayed haemolytic transfusion reaction (DHTR) occurring as a result of an undetected or unknown antibody. In this systemic review and meta-analysis, we aimed to investigate improvements to patient outcomes that could be achieved through the implementation of a national antibody registry. A series of searches through PubMed and SCOPUS identified a collection of articles with relevant information, restricted to full text, English language articles available through the RMIT Library service. 25 articles were considered for the review, four of these found to have relevant, extractable data for use in the meta-analysis. Alloantibody evanescence rates were analysed for the potential for reducing DHTRs associated with transfusion services, returning significant results indicating antibody evanescence rates of up to 68.4% in one study, with p-values less than 0.001. Due to the small number of included studies however, the interference values were quite high for these analyses at greater than 90% for each. Additional, beneficial side-effects of such a system were also considered, along with reductions in DHTRs. In conclusion it was determined that a National antibody registry would contribute to improving patient outcomes, however further studies could be performed to determine a stronger correlation, and exact levels of improvement that could be achieved.
尽管有严格的检测方案，但由于存在未检测到或未知的抗体，迟发性溶血性输血反应（DHTR）仍有发生的可能性。在这项系统评价和荟萃分析中，我们旨在研究通过建立国家抗体登记系统能否改善患者预后。通过在PubMed和SCOPUS上进行一系列检索，我们找到了一批包含相关信息的文章，这些文章仅限于可通过皇家墨尔本理工大学图书馆服务获取的全文英文文章。25篇文章被纳入综述，其中4篇被发现有可用于荟萃分析的相关、可提取数据。分析了同种抗体消失率与输血服务相关的减少DHTRs的可能性，一项研究得出了显著结果，表明抗体消失率高达68.4%，p值小于0.001。然而，由于纳入研究数量较少，这些分析的干扰值相当高，每项均大于90%。除了减少DHTRs外，还考虑了这种系统的其他有益副作用。总之，确定国家抗体登记系统将有助于改善患者预后，然而，可以进行进一步的研究以确定更强的相关性以及可实现的具体改善水平。
