Pandey Prashant, Tiwari Aseem, Shekhar Das Sudipta, Shastry Shamee, Kute Vivek, Chowdhry Mohit, Marik Arghyadeep, Aggarwal Geet, Kumari Supriya, Setya Divya, Mandal Saikat, Ranjan Shweta
Department of Transfusion Medicine & Transplant Immunology, Jaypee Hospital, Sector, 128, Noida 201304, India.
Department of Transfusion Medicine, Medanta, The Medicity, Gurugram, India.
Transfus Apher Sci. 2024 Feb;63(1):103862. doi: 10.1016/j.transci.2023.103862. Epub 2023 Dec 22.
ABO-incompatible transplantations allow patients to receive timely transplants. Isoagglutinin titration to ascertain levels of incompatible antibodies in the recipient is important in determining patient selection and transplant survivability. To find out the prevalent trends in India, the largest, first of its kind survey was carried out among the transplant centers regarding their practices in isoagglutinin titration.
The survey was drafted by a working group of Transfusion and Transplant Immunology specialists from six different centers. Data was obtained via the use of an online questionnaire.
Results were categorized into four categories, Hospital information, Titration methodology, Role of transfusion specialists and cut-off titers. Most centers had a well-established solid-organ transplant program with considerable number of ABO-incompatible transplantations. Most centers performed isoagglutinin titration in Transfusion Medicine department. Column Agglutination Technique (CAT) was the most common method, using EDTA blood samples and freshly-prepared in-house pooled cells. Most centers had a turn-around time of less than 12 h. While the policy for ascertaining baseline and threshold titers is well-defined in ABO-incompatible renal transplants, variations from center to center still exist for ABO-incompatible liver transplants. Most centers required a Transfusion Medicine consultation for the patients before such transplants.
With increasing ABO-incompatible kidney and liver transplants across the country, the role of Transfusion medicine specialists has become vital in pre-conditioning regimes enabling the viability and success of such transplants. This was a unique survey that provided a snapshot of current trends and practices of isoagglutinin titration for ABO-incompatible transplants in India.
ABO血型不相容移植使患者能够及时接受移植。通过测定同种凝集素滴度以确定受者体内不相容抗体水平，对于患者选择和移植存活率的判定至关重要。为了解印度的流行趋势，在各移植中心开展了有史以来规模最大的首次此类调查，内容涉及它们在同种凝集素滴度测定方面的做法。
该调查由来自六个不同中心的输血与移植免疫学专家工作小组起草。通过在线问卷获取数据。
结果分为四类，即医院信息、滴定方法、输血专家的作用和临界滴度。大多数中心拥有成熟的实体器官移植项目，且有相当数量的ABO血型不相容移植案例。大多数中心在输血医学科进行同种凝集素滴度测定。柱凝集技术（CAT）是最常用的方法，使用乙二胺四乙酸（EDTA）抗凝血样本和新鲜制备的内部混合细胞。大多数中心的周转时间少于12小时。虽然在ABO血型不相容肾移植中，确定基线和阈值滴度的政策已明确，但在ABO血型不相容肝移植方面，各中心仍存在差异。大多数中心在此类移植前要求对患者进行输血医学会诊。
随着全国范围内ABO血型不相容肾移植和肝移植的增加，输血医学专家在预处理方案中的作用对于此类移植的可行性和成功变得至关重要。这是一项独特的调查，提供了印度ABO血型不相容移植同种凝集素滴度测定的当前趋势和做法的概况。
