对于RHD抗原的模糊血清类型的患者,可以避免使用RHD阴性红细胞
David Juhl1, Kathrin Luckner1, Christian Brockmann1
1Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany.
Transfusion
|December 23, 2023
概括
将RHD阳性 (RHD+) 红细胞 (RBC) 输血给RHCE表型中具有C和/或E的患者可以最大限度地降低抗D免疫风险. 这一策略还可以防止不必要的输血RHD-负 (RHD-) RBCs对模两可的RHD类型化结果.
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:
- 血清RHD类型是至关重要的,但由于异常的RHD变体,可以产生模糊的结果.
- 模两可的结果需要分子RHD类型和谨慎的输血策略来防止抗D的形成.
- 目前的做法可能会导致不必要的输血RHD阴性红细胞缩物,造成浪费.
研究的目的:
- 为了评估对RHD输入结果模糊的患者的输血策略.
- 为了确定不同输血协议中抗D形成的风险.
- 为了评估不必要输血的RHD阴性红细胞度的比例.
主要方法:
- 对112名患者的回顾性分析,有模糊的血清和分子RHD类型化结果.
- 对五种输血策略的评估,从普遍的RHD阳性输血到普遍的RHD阴性输血.
- 评估每种策略的抗D形成风险和不必要的RHD阴性红细胞度使用情况.
主要成果:
- 将RHD阳性红细胞输血给RHCE表型中具有C和/或E的患者的策略导致抗D形成的风险为1.0%.
- 这一策略也导致只有0.9%的不必要输血RHD阴性红细胞缩物.
- 其他策略显示免疫的风险更高或RHD负单位的浪费更大.
结论:
- 将RHD阳性红细胞输血给具有C和/或ERHCE表型的患者是一种安全有效的策略,用于管理模两可的RHD类型化结果.
- 这种方法有效地平衡了抗D免疫的风险,避免了RHD阴性红细胞度浪费.
- 建议这种策略适用于等待分子RHD类型化结果的患者.
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