Pandey Prashant, Setya Divya, Singh Mukesh Kumar
Department of Transfusion Medicine, Histocompatibility and Molecular Biology, Jaypee Hospital, Sector-128, Noida, 201304 India.
Indian J Hematol Blood Transfus. 2022 Jul;38(3):577-584. doi: 10.1007/s12288-021-01506-w. Epub 2022 Feb 20.
Transfusion of RhD positive red cells to RhD negative individuals is not routine transfusion practice for the fear of alloimmunization. Aim of this study was to prospectively evaluate rate of alloimmunization after transfusion of RhD positive red cells in RhD negative individuals and to assess delay in transfusion due to decision making. This was a prospective, observational study conducted from 2014 to 2018. All patients were followed up for a period of three months, at 3, 14, 45 and 90 days with antibody screening. In addition, patients who were immunosuppressed and alloimmunized were followed up at 6 months and one year. During the period of the study, there were a total of 57 RhD negative patients (52 males and five females) who received a mean of 4.42 ± 2.85 transfusions. Alloimmunization was detected in 8 (14.03%) patients at a mean interval of 25.63 ± 16.04 days. Anti-D was detected in seven and one patient developed anti-E alloantibody. Mean number of red cell units transfused in alloimmunized was 1.7 ± 0.26 while it was 5.4 ± 1.82 in non-alloimmunized group. There was no delay in providing units to these patients. The TAT was found to be 68 min. Rate of alloimmunization after transfusion of RhD positive red cells to RhD negative individuals was found to be 12.3%. In life saving conditions, RhD negative patients can be transfused RhD positive red cells without delay in decision making.
由于担心同种免疫，向RhD阴性个体输注RhD阳性红细胞并非常规输血操作。本研究的目的是前瞻性评估RhD阴性个体输注RhD阳性红细胞后同种免疫的发生率，并评估因决策导致的输血延迟。这是一项于2014年至2018年进行的前瞻性观察性研究。所有患者均接受了为期三个月的随访，分别在第3、14、45和90天进行抗体筛查。此外，对免疫抑制和发生同种免疫的患者在6个月和1年时进行了随访。在研究期间，共有57例RhD阴性患者（52例男性和5例女性）接受了平均4.42±2.85次输血。在8例（14.03%）患者中检测到同种免疫，平均间隔时间为25.63±16.04天。7例检测到抗-D，1例患者产生了抗-E同种抗体。发生同种免疫的患者输注红细胞单位的平均数为1.7±0.26，而未发生同种免疫的组为5.4±1.82。向这些患者提供血制品没有延迟。发现输血周转时间为68分钟。向RhD阴性个体输注RhD阳性红细胞后的同种免疫发生率为12.3%。在挽救生命的情况下，RhD阴性患者可以立即输注RhD阳性红细胞，无需延迟决策。
