使用血型基因定型对患有状细胞病的儿童进行输血,当黑人捐赠者的数量有限时
Gabriel André Leiva-Torres1, Maude Cigna2, Jessica Constanzo-Yanez1
1Hema-Quebec, Transfusion Medicine, Montreal, Canada.
Transfusion
|March 18, 2024
概括
对于状细胞病 (SCD) 患者来说,寻找兼容的血液是具有挑战性的,因为非免疫接种的风险和有限的黑人献血者. 虽然确定了Rh兼容的捐赠者,但更大规模招募黑人捐赠者对于稳定的血液供应至关重要.
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 是一个遗传学.
背景情况:
- 红细胞输血对于状细胞疾病 (SCD) 的管理至关重要.
- 输血后的Alloimmunization通过限制血液选择而使治疗复杂化.
- 建议进行标准抗原匹配 (ABO,D,C,E,K),但在有限的黑人捐赠池中具有挑战性.
研究的目的:
- 评估儿科SCD患者中RH和FY基因变异的流行率.
- 评估为SCD患者找到RhCE匹配捐赠者的能力.
- 确定捐赠者人口统计学对输血兼容性的影响.
主要方法:
- 对205名儿科SCD患者进行前性队列研究.
- 对RH和FY基因进行基因定型.
- 输血和免疫史的分析.
- 对RhCE匹配单位的供体数据库的评估.
主要成果:
- 高频率的RHCE变异 (54.1%),特别是影响RH5 (e) 抗原.
- 在患者队列中,免疫接种率为20.7%.
- 黑人捐献者的有限可用性 (1.40%) 影响了对罕见Rh变异的兼容单元的获取.
- 确定了Rh相容的捐赠者,但可用性和扩展的表型匹配仍然是问题.
结论:
- 虽然可以识别Rh相容的捐赠者,但对SCD患者来说,一致的可用性和完整的抗原匹配是重大挑战.
- 黑人献血者的有限招募构成了提供及时和充足的输血的关键障碍.
- 增加招募黑人献血者的努力对于满足状细胞病患者的输血需求至关重要.
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