Etablissement français du sang, Hôpital Henri Mondor, 1 rue Gustave Eiffel, 94010 Créteil, France; Laboratoire d'hématologie, Centre hospitalier universitaire Angers, 4 rue Larrey, 49100 Angers, France.
Laboratoire de biochimie, AP-HP, Hôpital Henri Mondor, 1 rue Gustave Eiffel, 94010 Créteil, France; INSERM U955 équipe 2, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.
Transfus Clin Biol. 2024 Aug;31(3):130-134. doi: 10.1016/j.tracli.2024.03.002. Epub 2024 Mar 9.
Transfusion has a central place in the treatment of patients with sickle cell disease (SCD). Matching blood groups of red blood cell (RBC) units with the blood groups of the patient is essential to prevent alloimmunization and delayed hemolytic transfusion reaction. African ancestry donors have the best phenocompatibility with patients of the same origin, however their RBCs may present characteristic that can alter quality of the unit such as glucose-6-phosphate dehydrogenase (G6PD) deficiency. The objective is to analyze transfusion protocol, immunization rate and mismatch situations of SCD recipients and to evaluate the frequency of G6PD deficiency in RBCs units from African ancestry donors.
Samples of units transfused to SCD patients were analyzed. Transfusion data were collected from institutional databases. The activity of G6PD was measured in the segment of the RBC units.
A total of 98 segments of units transfused to 37 SCD recipients in 41 transfusions episodes was collected. Among patients, 35.1% (n = 13) had no antibodies; 10.8% (n = 4) had antibodies against Fy/Fy, Jk/Jk, M/N, S/s; 21.6% (n = 8) against RH/K antigens. In all cases, the protocols were in line with the recommendations. G6PD deficiency was observed in 9 units, that were all collected from Afro-Caribbean donors.
The transfusion protocol is established to prevent immunological reactions due to disparities in blood group antigens between donors and SCD recipients. However, the units of African ancestry donors, which allowed the best compatibility, displayed a high rate of G6PD deficiency. The storage and recovery impact of this deficiency must be evaluated.
输血在治疗镰状细胞病(SCD)患者中占有重要地位。为了防止同种免疫和延迟溶血性输血反应,将红细胞(RBC)单位的血型与患者的血型相匹配至关重要。非洲血统的供体与同一来源的患者具有最佳的表型相容性,但他们的 RBC 可能具有改变单位质量的特征,例如葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症。本研究旨在分析 SCD 受者的输血方案、免疫率和不匹配情况,并评估来自非洲血统供体的 RBC 单位中 G6PD 缺乏症的频率。
分析输注给 SCD 患者的单位样本。从机构数据库中收集输血数据。在 RBC 单位的片段中测量 G6PD 的活性。
共收集了 37 名 SCD 患者的 41 次输血事件中的 98 个单位片段。在患者中,35.1%(n=13)无抗体;10.8%(n=4)有针对 Fy/Fy、Jk/Jk、M/N、S/s 的抗体;21.6%(n=8)有针对 RH/K 抗原的抗体。在所有情况下,方案都符合建议。有 9 个单位存在 G6PD 缺乏症,均来自非洲裔加勒比海供体。
输血方案的建立是为了防止由于供体和 SCD 受者之间的血型抗原差异而引起的免疫反应。然而,允许最佳相容性的非洲血统供体的单位显示出高 G6PD 缺乏率。必须评估这种缺乏症对储存和恢复的影响。