Transfusões sanguíneas realizadas em um hospital do sul de Santa Catarina: características dos pacientes e reações transfusionais relacionadas / Blood transfusions performed at a hospital in southern Santa Catarina: characteristics of patients and related transfusion reactions

Introdução: As transfusões de hemoderivados não são totalmente isentas de reações adversas, sendo necessário um controle rigoroso das práticas que envolvem as transfusões para reduzir os riscos relacionados. Objetivo: Mensurar as transfusões de hemoderivados realizadas no Hospital Nossa Senhora da Conceição de Tubarão/SC e caracterizar o perfil dos pacientes transfundidos e reações adversas relacionadas ao procedimento. Métodos: Foi realizado um estudo transversal a partir dos dados referentes aos pacientes internados no Hospital Nossa Senhora da Conceição que receberam transfusão de hemoterápicos, no período de julho de 2014 a junho de 2015. Resultados: Foram analisadas 6.262 transfusões e 12 reações adversas notificadas relacionadas a essas transfusões. O perfil predominante dos pacientes foi o sexo masculino (56,8%), internados pelo Sistema Único de Saúde (SUS) (79,8%), e em leitos de enfermaria (37,3%). Os tipos sanguíneos mais prevalentes foram o tipo O e tipo A, os quais, somados, corresponderam a 87% dos pacientes com necessidade de transfusão, e 86,8% dos pacientes tinham fator Rh positivo. A maioria (78,5%) dos pacientes transfundidos recebeu o hemocomponente concentrado de hemácias (CH). O principal sinal pós-transfusão encontrado foi a febre (41,7%). Conclusão: A taxa de reações adversas encontradas foi menor que a média brasileira, sugerindo bom controle transfusional.

Introduction: Blood product transfusions are not completely free from adverse reactions, and rigorous control of practices involving transfusions should be enforced to reduce related risks. Objective: To measure blood product transfusions performed at Hospital Nossa Senhora da Conceição, in Tubarão-SC, and characterize the profile of patients who received transfusions as well as adverse reactions related to this procedure. Methods: This is a cross-sectional study performed with data from hospitalized patients at Hospital Nossa Senhora da Conceição who received blood product transfusions from July 2004 to June 2015. Results: We analyzed 6,262 transfusions and 12 reports of adverse reactions related to these procedures. Most of the patients were male (56.8%), hospitalized through the Unified Health System (SUS) (79.8%) in general wards (37.3%). The most prevalent blood types were O and A, which together accounted for 87% of patients requiring transfusions; 86.8% of all patients were Rh-positive. Most (78.5%) patients who underwent transfusions received packed red blood cells (PRBC). The main sign observed after transfusions was fever (41.7%). Conclusion: The rate of adverse reactions observed in this study was lower than the Brazilian average, suggesting an adequate management of transfusion procedures.

Prevalence of dog erythrocyte antigen 1, determined via immunochromatography, in domestic dogs in Korea / 대한수의학회지

Blood group determination in dogs is an important factor in transfusion medicine to minimize immediate or delayed adverse reactions after red blood cells transfusion in small animal clinics. Dog erythrocyte antigen (DEA) 1 is the most important blood type due to its high degree of antigenicity causing acute transfusion adverse reactions. The aim of this study was to investigate the prevalence of DEA 1 in various dog breeds in Korea. As a result of testing 592 blood samples from more than 35 dog breeds, DEA 1 blood typing for each breed showed that 57.8% of Malteses, 63.3% of Poodles, 76.2% of Mastiff-like dogs, 72.5% of Pomeranians, 47.7% of Shih Tzus, 70.3% of mixed breeds, 60.0% of Yorkshire Terriers, and 71.4% of Beagles were DEA 1-positive. Miniature Schnauzers and Jindo breeds had a significantly high prevalence (100%) of DEA 1-positive dogs compared to that in other small breed dogs. This is the first report of immunochromatography-detected DEA 1 prevalence in various domestic dog breeds. Although additional studies need clarifying the potential blood transfusion risks in domestic breed dogs with DEA 1, the results of this study may be useful when selecting a blood donor.

Confirm fusion cell line by STR technology of parentage identification / 中国医师杂志

Objective To screen and confirm cell fusion by DNA technology of parentage identification based on detecting of short tandem repeats.Methods With 20％ polyethylene glycol (PEG)-6000,human myeloma cell lines and health individual peripheral blood mononuclear cell were fused.Then selected by hypoxantin,aminopterin,thymidin (HAT) medium,and fusion cell were sub-cloned.Morphology of fusion cells was checked by regular microscope.Concentration of DNA was compared to parental cells.Allele genes,identified by short tandem repeats,of fusion cell line were sequenced and compared with each other.Results The fused cells from myeloma cell line and peripheral blood mononuclear cell (PBMC) were slightly larger than primary cells,and the proliferation cycle was not changed significantly.DNA concentration of the fused cell DNA was increased by two times.Sequences of short tandem repeats (STR) showed that the fused cell included all original genetic materials of parent cells.Conclusions DNA technology of parentage identification is a convenient and reliable method to screen and confirm fused cell.

Investigation on influences of vitamin C,KCL and dicynone on 3 kinds of blood cross matching method / 国际检验医学杂志

Objective To comprehend the influences of vitamin C ,KCL and dicynone on blood cross matching of saline and mi-crocolumn gel and to compare them with polybrene crossing matching .Methods Under the conditions with and without the specific antibody ,KCI injection ,dicynone injection ,vitamin C injection and normal saline were added for conducting the immunological reac-tion with corresponding RBC .The influences of 3 kinds of drug on different medium cross matching methods of different mediums . Results The low concentration of vitamin C and KCL does not affect polybrene cross matching ,dicynone makes the experiment to generate pseudoagglutination ;the high concentration of these 3 kinds of drug can cause the test to fail .The sensitivity of the saline medium method is slightly lower ,the influence of vitamin C and KCL on the test is inapparent ,while in the KCL method ,with the dilution of antibody ,the agglutination intensity is weakened and even disappeared .Conclusion 3 kinds of drug all have influences on the mierocolumn gel cross matching method ,especially KCL .

Preoperative Selective Desensitization of Live Donor Liver Transplant Recipients Considering the Degree of T Lymphocyte Cross-Match Titer, Model for End-Stage Liver Disease Score, and Graft Liver Volume

Several studies have suggested that a positive lymphocyte cross-matching (XM) is associated with low graft survival rates and a high prevalence of acute rejection after adult living donor liver transplantations (ALDLTs) using a small-for-size graft. However, there is still no consensus on preoperative desensitization. We adopted the desensitization protocol from ABO-incompatible LDLT. We performed desensitization for the selected patients according to the degree of T lymphocyte cross-match titer, model for end-stage liver disease (MELD) score, and graft liver volume. We retrospectively evaluated 230 consecutive ALDLT recipients for 5 yr. Eleven recipients (4.8%) showed a positive XM. Among them, five patients with the high titer (> 1:16) by antihuman globulin-augmented method (T-AHG) and one with a low titer but a high MELD score of 36 were selected for desensitization: rituximab injection and plasmapheresis before the transplantation. There were no major side effects of desensitization. Four of the patients showed successful depletion of the T-AHG titer. There was no mortality and hyperacute rejection in lymphocyte XM-positive patients, showing no significant difference in survival outcome between two groups (P=1.000). In conclusion, this desensitization protocol for the selected recipients considering the degree of T lymphocyte cross-match titer, MELD score, and graft liver volume is feasible and safe.

Analysis of crossmatch in irregular antibody-positive patients / 中国基层医药

Objective To investigate the clinical significance of irregular antibody screening positive patients in the blood transfusion.Methods From September 2003 to September 2012,5 260 samples of blood test were given pre-transfusion irregular antibody detection,and the patients with positive antibody screening were statistically analyzed.Results Of 5 260 samples,38 cases (6.8％) had irregular antibodies,the difference between males and females was statistically significant(x2 =2.646,P ＜ 0.05).The Rh blood group had the highest proportion in irregular antibodies;pregnancy history and history of blood transfusion group,pregnancy history group,history of blood transfusion group were significantly higher than those without history of pregnancy and transfusion history groups,the difference was statistically significant (x2 =28.827,P ＜ 0.05).Conclusion Screening of irregular antibodies plays an important role in the safety of clinical blood transfusion.

Application of three automatic blood group testing instruments in cross matching test / 第二军医大学学报

Objective To apply three automatic blood group testing instruments, WADiana®(Diana), Techno TwinStation and ORTHO AutoVue Innova/Ultra, in clinical cross match test and to assess their effect, so as to ensure safe clinical blood transfusion. Methods The three instruments were used for cross matching test of 8 073 blood recipients and blood specimens of Shanghai Blood Center. The incompatible positive samples were reexamined by experiment cross matching antiglobulin test tube method. Results The 3 instruments detected 589 positive blood samples. There was no false positive result in the WADiana®(Diana) system; Techno TwinStation and ORTHO AutoVue Innova/Ultra analyzer had 6 and 19 false positive results, respectively. Conclusion All the three instruments can accurately detect the positive samples in clinical cross match test, and WADiana® system has a more prominent performance.

Identification and molecular analysis on an individual with para-Bombay Phenotype / 国际检验医学杂志

Objective To identify a case of Para-Bombay phenotype and analyze it's molecular background.Methods Routine serological methods were used to identify the antigens on red cells and antibodies in serum,the weak antigens on red cells were detected by absorption and elution test.ABO substances were determined by agglutination inhibition test in saliva.FUT1 and FUT2 gene were sequenced with molecular methods.Results The para-Bombay was confirmed as Ah-secretion.Two of the three T repeats located at the nucleotides 880-882 were deleted.This deletion causes the shifting of the open-reading frame.The FUT2 genotype was Se357Se357.Conclusion Para-Bombay phenotype is rare.Homozygous genotype of FUT1 allele,hh(nt880-882de1TT)might be the cause of H-antigens deficiency..The wild type of FUT2 allele was consistent with the secretor status.

Analysis of clinical factors for hypo-side agglutination in 81 cases in cross match blood test with microcolumn gel assay / 国际检验医学杂志

Objective To analyze the etiological factor for hypo-side agglutination in cross match blood test(CMT)with microcolumn gel assay,and to provide a guide to the clinical blood transfusion.Methods The data were collected and analyzed about 81 cases with hypo-side agglutination in CMT with microcolumn gel assay and direct antiglobulin test(DAT)positive from Jan.2007 to Oct.2008.Results Among the 81 hype-side agglutinated cases,most were with kidney disease,liver and gall disease,hematologic disease and immunologic disease.Specially,the kidney disease was most,accounting for 16.2%.Conclusion The analysis contributes to disposal in CMT and the safety of clinical blood transfusion.

Clinical application of microcolumn gel immunoassay in transfusion-related experiments / 国际检验医学杂志

Objective To explore the applicable value of microcolumn gel immunoassay(MGIA) in transfusion-related experiments(blood typing, cross matching, antibody titration), and carry out its methodical evaluation. Methods Fifteen anti-Rh D positive samples from 55 Rh D negative patients, twenty-one cases of discrepant blood typing and twenty-nine cross matching positive samples were studied by applying MGIA and routine tube test simultaneously. Antibody titer data from 853 pregnant women with type O were brought into statistics. Results In 55 Rh D negative samples, the positive rate of Rh D antibody tested by MGIA and tube test was 27.27%(15/55) and 21.82 % (12/55) respec-tively,and the samples with titer 1:4 above got the coincident results by the two methods. For twen-ty-one discrepant blood typing samples, 11 cases with weak reaction showed discrepant results by MGIA;however, all samples showed weak reaction by tube test. In 29 samples with cross matching positive by MGIA,2 cases were confirmed to be negative by tube test. For the pregnant women with type O,IgG antibody titer abnormal ratio was 33.18%(144/434) if their respective husbands was with type A,33.17%(139/419) if their respective husbands was with type B.Conclusion MGIA is charac-teristic of convenience, fastness and reliability of test results, but its false-positive or false-negative should be paid attention to. When abnormal results occur, traditional tube test as well asmicroscopic examination should be performed in parallel.

A case study of leukemia with irregular anti-Ce IgG antibody / 北京大学学报(医学版)

When we did compatibility testing, we found a case of leukemia with irregular antibody. The antibody specificity was identified as anti-Ce using panel-cell, and was IgG antibody. The anti-Ce antibody had both anti-C and anti-e activity. It is very difficult to find a Ce antigen negative blood for transfusion. The compatible donors rate is very low, only 2%-3%.