Baldwin M L, Ness P M, Barrasso C, Kickler T S, Drew H, Tsan M F, Shirey R S
Transfusion. 1985 Jan-Feb;25(1):34-8. doi: 10.1046/j.1537-2995.1985.25185116499.x.
The long-term survival of serologically incompatible red cell units was measured in five patients with antibodies to high-frequency antigens. Initially, the survival of 1 ml of 51Cr-labeled incompatible red cells was measured over 1 hour. After demonstrating that the 1-hour survival times were successful (greater than 70%), each patient then received 5 ml of the same 51Cr-labeled red cells followed by the transfusion of the remainder of the red cell unit. The long-term T 1/2Cr survival for each case was patient 1 (anti-McCa), 15 days; patient 2 (anti-JMH), 12 days; patient 3 (anti-Kna), 31 days; patient 4 (anti-McCa), 12 days; and patient 5 (anti-Hya), 14 days. Each antibody tested in an in vitro homologous macrophage assay showed less than 5 percent phagocytosis. Anti-JMH was the only antibody to react with IgG subclass antisera and was determined to be IgG4. The macrophage assay, IgG subclass testing, and short-term (1 hour, 1 ml) 51Cr survival studies all indicated that the short-term survival was good. However, only the measurement of long-term survival with transfused units of serologically incompatible red cells was able to determine the actual survival, and "clinical significance" of the alloantibodies. Determining the actual long-term survival by the method described here can be of importance for patients requiring chronic red cell transfusion.
对五名具有高频抗原抗体的患者进行了血清学不相容红细胞单位的长期存活情况测定。最初，在1小时内测定1ml经51Cr标记的不相容红细胞的存活率。在证实1小时存活时间成功（大于70%）后，每位患者随后接受5ml相同的经51Cr标记的红细胞，然后输注红细胞单位的其余部分。各病例的长期51Cr半衰期存活时间分别为：患者1（抗-McCa），15天；患者2（抗-JMH），12天；患者3（抗-Kna），31天；患者4（抗-McCa），12天；患者5（抗-Hya），14天。在体外同源巨噬细胞试验中检测的每种抗体的吞噬作用均小于5%。抗-JMH是唯一与IgG亚类抗血清发生反应的抗体，被确定为IgG4。巨噬细胞试验、IgG亚类检测和短期（1小时，1ml）51Cr存活研究均表明短期存活良好。然而，只有通过输注血清学不相容红细胞单位来测量长期存活情况，才能确定同种抗体的实际存活情况和“临床意义”。通过此处描述的方法确定实际长期存活情况对于需要长期红细胞输血的患者可能具有重要意义。
