反对注入来自所有血液成分的ABO不兼容抗体和抗原的情况
Nicholas Tong1, Debra Masel2, Phuong-Lan Nguyen2
1Department of Pathology and Laboratory Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11550, United States.
概括
输血不相同的血液成分,虽然方便,但可以通过引起免疫反应和伤害来伤害患者. 建议使用ABO相同的血液成分来提高患者的安全性和降低死亡风险.
科学领域:
- 输血医学 输血医学
- 免疫学 免疫学 免疫学
- 患者安全 患者安全
背景情况:
- 目前的做法是输血ABO相容,但不一定相同的血液成分.
- 这种方法通过减少血液产品的到期时间来简化库存管理.
- 然而,这些输血会导致免疫复合体的形成,血液溶解和细胞损伤.
研究的目的:
- 评估输血的安全性和后果 ABO 兼容与 ABO 相同的血液成分.
- 评估当前输血实践与患者不良结果之间的关联.
- 倡导在血液成分输血中修订护理标准.
主要方法:
- 对 ABO 兼容和不兼容的输血现有证据的审查.
- 对与不同输血策略相关的患者结果的分析.
- 对非相同血液成分输血的免疫和细胞效应的评估.
主要成果:
- 输血的 ABO 兼容但不相同的组件与免疫复合体,血液溶解和细胞损伤有关.
- 有证据表明,这些做法与患者死亡率增加之间存在因果关系.
- 当前的做法虽然缓解了库存,但也带来了重大风险.
结论:
- 输血与ABO兼容,非相同的血液成分的做法与患者的不良结果有关,包括增加死亡率.
- 避免ABO不兼容的抗体,细胞和可溶性抗原至关重要.
- 在可行的情况下,采用提供ABO相同血液成分的政策应该成为最佳的护理标准,以提高患者的安全.
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