Wilhelm D, Klüter H, Klouche M, Kirchner H
Institute of Immunology and Transfusion Medicine, School of Medicine, University of Lübeck, Germany.
Vox Sang. 1995;69(3):217-21. doi: 10.1111/j.1423-0410.1995.tb02598.x.
There has been some discussion whether the atopic disposition of a blood donor is associated with a potentially higher incidence of hypersensitivity nonhemolytic transfusion reactions (NHTRs). Serum samples from patients who had suffered from NHTRs and samples from the platelet concentrates (PCs) responsible for the reactions were examined for total and specific IgE as diagnostic markers for allergic events. In addition, the allergy prevalence among 1,088 blood donors was determined to analyze the allergy prevalence among our blood donors. Our results indicate that in 90% of cases, allergic NHTRs were associated with specific IgE antibodies in the recipient's serum, indicating the allergic disposition of the patient. In contrast, specific IgE antibodies were detected in only 22% in the transfused PCs. However, among all investigated NHTRs, there was not a single case in which specific IgE antibodies were detected exclusively in the PC. The allergy prevalence among our blood donors was about 26%. In our opinion, the few cases in which the allergic disposition of blood donors in combination with the allergic disposition of the recipients was associated with NHTRs reflects the allergy prevalence among our blood donors in general (26%). On the basis of these findings, we conclude that allergy diagnosis for blood donors is only of minor value in the prevention and prediction of NHTRs, whereas allergy diagnosis for patients who require multiple PC transfusion might be helpful.
关于献血者的特应性体质是否与更高的超敏非溶血性输血反应（NHTRs）发生率相关，一直存在一些讨论。对曾发生NHTRs的患者的血清样本以及引发反应的血小板浓缩物（PCs）样本进行检测，以检测总IgE和特异性IgE作为过敏事件的诊断标志物。此外，测定了1088名献血者的过敏患病率，以分析我们献血者中的过敏患病率。我们的结果表明，在90%的病例中，过敏性NHTRs与受者血清中的特异性IgE抗体相关，表明患者具有过敏体质。相比之下，在输注的PCs中仅22%检测到特异性IgE抗体。然而，在所有调查的NHTRs中，没有一例仅在PC中检测到特异性IgE抗体。我们献血者中的过敏患病率约为26%。我们认为，献血者的过敏体质与受者的过敏体质相结合与NHTRs相关的少数病例反映了我们献血者总体的过敏患病率（26%）。基于这些发现，我们得出结论，对献血者进行过敏诊断在预防和预测NHTRs方面价值不大，而对需要多次输注PCs的患者进行过敏诊断可能会有所帮助。
