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泰国一家三级护理医院成年患者中采用固相红细胞黏附试验评估血小板交叉配型有效性的回顾性研究。

Evaluation of the effectiveness of platelet crossmatching by the solid-phase red cell adherence assay in adult patients of a tertiary care hospital in Thailand: A retrospective study.

作者信息

Sinwatcharaphirom Thunnakhon, Apisawes Kusuma, Kittivorapart Janejira

机构信息

Department of Transfusion Medicine, Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand.

出版信息

Health Sci Rep. 2022 Aug 12;5(5):e769. doi: 10.1002/hsr2.769. eCollection 2022 Sep.

DOI:10.1002/hsr2.769
PMID:35983548
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9375133/
Abstract

BACKGROUND AND AIMS

Platelet transfusion refractoriness is well aware to be associated with poor clinical outcomes. Patients with the alloantibody causing refractoriness required cross-matched compatible products to improve the platelet number. This study aims to evaluate the effectiveness and availability of platelet crossmatching provided by the solid-phase red cell adherence (SPRCA) technique in the context of a tertiary university hospital.

METHODS

A retrospective chart review was performed of the records of 214 patients with platelet refractoriness in Siriraj Hospital, a tertiary university hospital in Thailand, between January 1, 2017, and December 31, 2020.

RESULTS

The SPRCA technique successfully provided cross-matched compatible platelets to 114 patients (69.7%). Platelet crossmatching significantly improved the platelet counts, as shown by the increased 1- and 24-h corrected-count increments (< 0.0001). No acute transfusion reactions were observed in these patients. Of the 114 patients who received cross-matched platelets, 82 patients (71.9%) survived at 30-day posttransfusion; whereas, 16 patients (14.0%) died within 7-day posttransfusion.

CONCLUSION

The SPRCA method can provide a high availability rate of cross-matched platelets, which is effective at stopping and preventing clinical bleeding conditions. This method is appropriate to apply for platelet crossmatching in the context of a hospital blood bank.

摘要

背景与目的

血小板输注无效与不良临床结局密切相关。由同种抗体导致输注无效的患者需要输注交叉配型相合的产品以提高血小板数量。本研究旨在评估在一所三级大学医院中,采用固相红细胞吸附(SPRCA)技术进行血小板交叉配型的有效性和可行性。

方法

对泰国一所三级大学医院诗里拉吉医院2017年1月1日至2020年12月31日期间214例血小板输注无效患者的病历进行回顾性分析。

结果

SPRCA技术成功为114例患者(69.7%)提供了交叉配型相合的血小板。血小板交叉配型显著提高了血小板计数,1小时和24小时校正计数增加值增加即表明了这一点(<0.0001)。这些患者未观察到急性输血反应。在接受交叉配型血小板的114例患者中,82例患者(71.9%)在输血后30天存活;而16例患者(14.0%)在输血后7天内死亡。

结论

SPRCA方法可提供较高的交叉配型血小板可得率,对止血和预防临床出血情况有效。该方法适用于医院血库进行血小板交叉配型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f035/9375133/d1aa9728cb43/HSR2-5-e769-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f035/9375133/d1aa9728cb43/HSR2-5-e769-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f035/9375133/d1aa9728cb43/HSR2-5-e769-g001.jpg

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本文引用的文献

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Transfus Apher Sci. 2020 Oct;59(5):102842. doi: 10.1016/j.transci.2020.102842. Epub 2020 Jun 9.
2
Efficacy of cross-match compatible platelets in multi transfused haemato-oncology patients refractory to platelet transfusion.交叉配型相合血小板对多次输血且血小板输注无效的血液肿瘤患者的疗效
Transfus Apher Sci. 2019 Dec;58(6):102657. doi: 10.1016/j.transci.2019.09.010. Epub 2019 Oct 22.
3
Risk of bleeding and use of platelet transfusions in patients with hematologic malignancies: recurrent event analysis.
血液系统恶性肿瘤患者的出血风险及血小板输注的使用:复发事件分析
Haematologica. 2015 Jun;100(6):740-7. doi: 10.3324/haematol.2014.118075. Epub 2015 Mar 20.
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Prevalence of platelet-specific antibodies and efficacy of crossmatch-compatible platelet transfusions in refractory patients.难治性患者中血小板特异性抗体的患病率及交叉配型相容血小板输注的疗效
Transfus Med. 2014 Dec;24(6):406-10. doi: 10.1111/tme.12157. Epub 2014 Oct 19.
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Evaluation of platelet cross-matching in the management of patients refractory to platelet transfusions.血小板交叉配型在血小板输注难治性患者管理中的评估。
Blood Transfus. 2014 Apr;12(2):187-94. doi: 10.2450/2014.0120-13.
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Longitudinal management with crossmatch-compatible platelets for refractory patients: alloimmunization, response to transfusion, and clinical outcomes (CME).对于难治性患者进行交叉配型相容血小板的纵向管理:同种免疫、输血反应和临床结局(CME)。
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