Chaplin H, Hunter V L, Rosche M E, Shirey R S
Transfusion. 1985 Jan-Feb;25(1):39-43. doi: 10.1046/j.1537-2995.1985.25185116500.x.
The present study documents immediate and long-term survival of crossmatch-incompatible Rh(D)-negative donor red cells in a patient with anti-LW. A 67-year-old group A Rh(D)-positive man was admitted for urgent coronary artery bypass surgery. The direct antiglobulin test (DAT) was weakly positive in two of five laboratories. His serum contained anti-LW (two laboratories); his red cells were LW negative (three antisera). Two siblings were LW-positive. Surgery was delayed, and 3 ml Rh(D)-negative crossmatch-incompatible red cells stored in citrate-phosphate-dextrose-adenine-one were labeled with 25 microCi of 51Cr and injected. Immediate survival was approximately 100 percent with 92 percent survival at 20 hours. Six daily blood samples showed a decreased red cell lifespan, (T 1/2 = 14 days). Because of medical complications, 4 units of Rh(D)-negative crossmatch-incompatible blood were then transfused without clinical or hemolytic reaction. The anti-IgG DAT became stronger. In vivo survival of the remaining 51Cr-RBCs became normal (T 1/2 28 days over the succeeding 20 days). Following transfusion, no change in serum antibody strength was demonstrated by double-blind titration of seven coded samples. The observations support modest reduction of lifespan for 3 ml of LW-positive red cells, but normal survival following subsequent transfusion of approximately 700 ml of LW-positive red cells.
本研究记录了在一名患有抗LW抗体的患者中，交叉配血不相容的Rh(D)阴性供者红细胞的即刻和长期存活情况。一名67岁的A血型Rh(D)阳性男性因紧急冠状动脉搭桥手术入院。在五个实验室中的两个，直接抗球蛋白试验（DAT）呈弱阳性。他的血清中含有抗LW（两个实验室检测结果）；他的红细胞LW阴性（三种抗血清检测结果）。两名同胞为LW阳性。手术推迟，将3毫升保存在枸橼酸盐-磷酸盐-葡萄糖-腺嘌呤-1中的Rh(D)阴性交叉配血不相容红细胞用25微居里的51Cr标记后注入。即刻存活率约为100%，20小时时存活率为92%。连续六天采集的血样显示红细胞寿命缩短（T 1/2 = 14天）。由于医疗并发症，随后输注了4单位Rh(D)阴性交叉配血不相容血液，未出现临床或溶血反应。抗IgG DAT变强。剩余51Cr标记红细胞的体内存活情况恢复正常（在随后的20天内T 1/2为28天）。输血后，通过对七个编码样本进行双盲滴定，未发现血清抗体强度有变化。这些观察结果支持3毫升LW阳性红细胞的寿命略有缩短，但在随后输注约700毫升LW阳性红细胞后存活正常。
