Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Seoul, South Korea.
Transfus Apher Sci. 2023 Oct;62(5):103765. doi: 10.1016/j.transci.2023.103765. Epub 2023 Jul 21.
The unexpected antibody test is an essential for ensuring the safety of blood transfusions. In infants, different pre-transfusion tests and transfusion strategies are needed due to their immature antigen/antibody system. This study aims to analyze the pattern of unexpected antibodies and their clinical significance in infants.
A retrospective analysis was conducted on the results of unexpected antibody identification tests performed on infants under one year of age at Asan Medical Center from 1999 to 2022. Patients' unexpected antibody identification test results and clinical information were investigated. The results of unexpected antibody identification and phenotype of each patient's mother were collected.
45 cases of antibody results were studied. 25 cases were found in infants under 4 months of age, and 18 cases (76%) were associated with hemolytic disease of the fetus and newborn (HDFN). The most common unexpected antibody in infants was anti-M (17 cases). There was one case of severe HDFN caused by anti-M. In 10 cases, anti-E and anti-c were found together, and 9 of these cases were associated with HDFN. There were four cases with a history of previous transfusion.
Non-ABO antibodies found in infants showed a different pattern compared to adults. Interpreting unexpected antibody tests in infants, it is important to consider the clinical status of the infant and the test results of the mother, due to possibility of HDFN. To our knowledge, this is the first study to reveal the distribution and clinical significances of unexpected antibodies found in infants in Korea.
意外抗体检测对于确保输血安全至关重要。由于婴儿的抗原/抗体系统尚未成熟，因此需要进行不同的输血前检测和输血策略。本研究旨在分析婴儿中意外抗体的模式及其临床意义。
对 1999 年至 2022 年在 Asan 医疗中心接受输血的一岁以下婴儿进行的意外抗体鉴定检测结果进行回顾性分析。调查了患者的意外抗体鉴定检测结果和临床信息。收集了每位患者母亲的意外抗体鉴定结果和表型。
研究了 45 例抗体结果。25 例发生在 4 个月以下的婴儿中，18 例（76%）与胎儿和新生儿溶血病（HDFN）有关。婴儿中最常见的意外抗体是抗-M（17 例）。有一例由抗-M 引起的严重 HDFN。有 10 例同时发现抗-E 和抗-c，其中 9 例与 HDFN 有关。有 4 例有既往输血史。
与成人相比，婴儿中发现的非 ABO 抗体表现出不同的模式。在解释婴儿的意外抗体检测结果时，由于可能存在 HDFN，因此需要考虑婴儿的临床状况和母亲的检测结果。据我们所知，这是首次在韩国揭示婴儿中意外抗体的分布和临床意义的研究。
