有证据表明,具有RH基因型变异的捐赠者与意想不到的Rh抗体有关
Julie Kirkegaard1, Lynsi Rahorst1, Anna Burgos2
1Immunohematology Reference Laboratory, Division of New York Blood Center Enterprises, Community Blood Center, Kansas City, Missouri, USA.
Transfusion
|September 1, 2023
概括
在状细胞病患者中,意外的Rh抗体可能来自对抗原阴性单元的输血,具有RH基因型变异. 这种情况将抗C与具有RH基因型变异的C阴性单元联系在一起,突显了需要仔细选择供体的必要性.
科学领域:
- 输血医学 输血医学
- 免疫学 免疫学 免疫学
- 遗传学 遗传学 是一个
背景情况:
- 在没有先前接触抗原阳性红细胞 (RBCs) 的状细胞病 (SCD) 患者中观察到意想不到的Rh抗体.
- 一种假设表明,这些抗体可能是由于输血的红细胞单位,是抗原阴性,但具有变异的RH基因型.
研究的目的:
- 调查输血红细胞单位与RH基因型变体之间的关联,以及SCD患者中意外Rh抗体的发展.
- 分析这种抗体形成的临床影响,包括其短暂性质和对输血管理的影响.
主要方法:
- 标准的血清学方法包括管和IgG凝测试用于血抗体查.
- 对患者和输血单位进行扩展的红细胞表型化和HEA/RH基因型化.
- 一个儿科SCD患者经历了输血后抗C抗体形成的详细案例研究.
主要成果:
- 在输入C阴性红细胞单元与RH基因型变异 (编码部分D和不常见的V/VS+ hrB-表型) 和患者抗C抗体的发展之间建立了直接联系.
- 抗C抗体和阳性直接抗球蛋白测试 (DAT) 是短暂的,持续25周.
- 没有证据表明输血红细胞的生存受损.
结论:
- 输血的红细胞单位与特定变异的RH基因型可以诱导意想不到的抗体,如抗C,在敏感的患者.
- 阳性DAT和温暖的自身抗体的存在使输血过程复杂化.
- 考虑患者和捐赠者的RH基因型对于预防alloimmunization和优化罕见献血的分配至关重要,特别是来自少数群体的献血者.
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