Floss A M, Strauss R G, Goeken N, Knox L
Transfusion. 1986 Sep-Oct;26(5):419-22. doi: 10.1046/j.1537-2995.1986.26587020115.x.
We conducted studies of both red cell (RBC) and leukocyte (WBC) antibody formation in infants following multiple transfusions given during the first weeks of life. Fifty-three infants received 683 RBC transfusions from 503 different donors, plus 62 platelet, 4 granulocyte, and 53 fresh-frozen plasma units during the first 4 months of life. Three hundred fifty serum samples were obtained before, during, and after the transfusions. None of the infants formed unexpected RBC antibodies when tested at 37 degrees C by a two-cell low-ionic-strength solution antibody screen that included an anti-globulin phase. Twenty posttransfusion serums were negative when tested at room temperature. Lymphocytotoxic and granulocytotoxic WBC antibodies were measured in posttransfusion serums from 13 infants, and none were found. Despite exposure to many RBC and WBC antigens, no infants produced alloantibodies against blood cell antigens. Thus, immunologically mediated transfusion reactions should be quite rare in young infants, and this study supports recommendations of the American Association of Blood Banks Standards to omit repeat RBC compatibility testing during the first 4 months of life in infants whose initial RBC antibody screens reveal no unexpected antibodies.
我们对出生后第一周内多次输血的婴儿进行了红细胞（RBC）和白细胞（WBC）抗体形成的研究。53名婴儿在出生后的前4个月内接受了来自503名不同供者的683次红细胞输血，外加62个血小板单位、4个粒细胞单位和53个新鲜冰冻血浆单位。在输血前、输血期间和输血后采集了350份血清样本。当通过包括抗球蛋白阶段的双细胞低离子强度溶液抗体筛查在37℃进行检测时，没有婴儿形成意外的红细胞抗体。20份输血后血清在室温下检测时呈阴性。对13名婴儿输血后的血清进行了淋巴细胞毒性和粒细胞毒性白细胞抗体检测，未发现此类抗体。尽管接触了许多红细胞和白细胞抗原，但没有婴儿产生针对血细胞抗原的同种抗体。因此，免疫介导的输血反应在幼儿中应该相当罕见，并且本研究支持美国血库协会标准中的建议，即在出生后前4个月内初次红细胞抗体筛查未发现意外抗体的婴儿中，省略重复的红细胞相容性检测。
