Bedford Russell A R, Rivers R P, Davey N
St Mary's Hospital Medical School, London.
Arch Dis Child. 1993 Jan;68(1 Spec No):49-51. doi: 10.1136/adc.68.1_spec_no.49.
The development of antihuman leucocyte antigen antibodies (aHLAA) in response to multiple transfusions in preterm infants was studied prospectively. Fifty seven infants requiring a minimum of two blood transfusions were recruited after obtaining informed written parental consent. They were randomised to receive either whole blood or blood that had been passed through a leucocyte filter. Anti-HLAA were sought in maternal and cord blood so as to ensure that any aHLAA detected after transfusion had not been passively transferred antenatally, and in 1 ml samples drawn monthly from the baby, at least 10 days from a previous transfusion, until discharge from hospital. Anti-HLAA were detected by microlymphocytotoxicity assay. Results were obtained in 42 babies, 19 in the filter and 23 in the no filter group. Fifteen babies had to be excluded because of protocol violation or because they died. None of the babies receiving filtered blood developed aHLAA, but seven babies in the no filter group developed aHLAA. In conclusion, multiply transfused preterm infants have the ability to elaborate antibodies to HLA and leucocyte filters may prevent this.
对早产儿多次输血后产生抗人白细胞抗原抗体（aHLAA）的情况进行了前瞻性研究。在获得家长书面知情同意后，招募了至少需要两次输血的57名婴儿。他们被随机分为接受全血组或经过白细胞滤器过滤的血液组。在母亲和脐带血中检测抗HLAA，以确保输血后检测到的任何aHLAA不是产前被动转移的，并且在婴儿每月抽取的1毫升样本中检测抗HLAA，距离上次输血至少10天，直至出院。通过微量淋巴细胞毒性试验检测抗HLAA。42名婴儿获得了结果，19名在过滤组，23名在未过滤组。15名婴儿因违反方案或死亡而被排除。接受过滤血液的婴儿均未产生aHLAA，但未过滤组有7名婴儿产生了aHLAA。总之，多次输血的早产儿有产生针对HLA抗体的能力，白细胞滤器可能会预防这种情况。
