通过亚洲型DEL红细胞单位对D阴性泰国患者进行抗D合免疫接种
Jairak Thongbut1, Caroline Bénech2, Niramon Phiri1
1National Blood Centre (NBC), Thai Red Cross Society, Bangkok, Thailand.
概括
一种罕见的血液变异称为DEL表型,在接受输血的D阴性患者中引起了抗D配免疫. 分子检测对于识别DEL献血者至关重要,以防止未来的免疫事件.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 遗传学 遗传学 是一个
背景情况:
- 罕见的Rh变体DEL表型,通常被误认为D-负,使用标准血清学测试.
- 具有DEL表型的个体可以在输血后在D阴性接受者中触发抗D合免疫.
- 之前的报道表明,在接受了DEL红细胞 (红细胞) 输血的D阴性患者中,抗D配免疫.
研究的目的:
- 在接受多次红细胞输血的D阴性患者中调查抗D合免疫的原因.
- 评估血清学和分子方法在识别DEL表型捐赠者的有效性.
- 突出分子测试在血液输血实践中对DEL等位基因查的重要性.
主要方法:
- 一名患有免疫缺陷综合征的D阴性患者从17名血清D阴性捐赠者那里获得了红细胞单位.
- 血清学测试,包括吸附-化和分子分析,在供体血液样本上进行.
- 确定了RHD基因变异来检测DEL表型.
主要成果:
- 患者在从最初被类型为D阴性的捐赠者接收红细胞后产生了抗D抗体.
- 分子分析在17名捐赠者中的5名中确定了亚洲型DEL等位基因.
- 在检测到抗D生产之前,这些DEL表型捐赠者中有4人为患者输血.
结论:
- 该病例代表了泰国首次报告的抗D与免疫接种,原因是亚洲型DEL红细胞输血在血清D阴性患者.
- 这些发现强调了在检测DEL表型时常规血清学类型化的局限性.
- 强烈支持实施DEL血液管理的具体政策,包括分子测试,以防止输血相关的非免疫化.
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