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1.
Chinese Journal of Blood Transfusion ; (12): 182-185, 2021.
Article in Chinese | WPRIM | ID: wpr-1004630

ABSTRACT

【Objective】 Toexplore the viability of preparing washed RBCs ordeglycerolized RBCs(referred as frozen RBCs)from blood containing irregular antibodies, so as to provide references for formulating processing procedures of blood containing irregular antibodiestosave blood resources and reduce blood wastage. 【Methods】 Once irregular antibodies were yielded, their type and titerwere determined.The plasma was discarded, and the suspended RBCs were prepared and processed according to the standardized washing scheme.The processing effect of blood with different titers and types of antibodies was observed, and theirfurther clinical application was followed up. 【Results】 From May 2017 to July 2019, a total of 45 blood samples containing irregular antibodies were screened in our center. The overall qualified rate reached 91.1% after processing. 100%(25/25) was qualified in IgM, and 80.0%(16/20)in IgG.4samples, initially noncom for mingdue to IgG-Dwith titerranged8~16, met the requirements after one or two additional washing processes. Among them, 23 cases were issued and appliedin clinicaland noadeverse reactions to blood transfusionoccurred. 【Conclusion】 After appropriate processing, blood containing irregular antibody can be applied to the clinical to save blood resources. When the irregular antibody is IgG-D and the titer is high, the washing times should be increased, and only when there is no residual antibodycan the samples be issued to the clinical.

2.
CES med ; 33(1): 3-12, ene.-abr. 2019. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1039326

ABSTRACT

Resumen Introducción: la aloinmunización se presenta entre 1,0-1,5 % de las personas expuestas a un antígeno externo o durante el embarazo, un trasplante o una transfusión. En los bancos de sangre se realiza la tamización de anticuerpos irregulares, diferentes a los del sistema ABO. Objetivo: estimar la prevalencia de anticuerpos irregulares en donantes de un banco de sangre de Medellín entre 2016 y 2018. Métodos: estudio transversal en 25 391 donantes. Se realizó control de sesgos de selección e información mediante aplicación de técnicas con excelente validez y control de calidad interno y externo, y detección mediante ID-card Liss/coombs en seis microtubos con anti-IgG y anti-C3d. El análisis se basó en medidas de resumen, frecuencias, chi cuadrado y prueba exacta de Fisher. Resultados: la edad promedio fue 34 años. La prevalencia de anticuerpos irregulares fue 0,30 %, siendo mayor anti-D con 0,071 %. No se hallaron diferencias según el sexo y el grupo etario; anti-D fue más frecuente en mujeres y donantes entre 31 y 40 años. Conclusión: se halló una alta prevalencia de anti-D y antiKell, que presentan gran importancia clínica después de los anticuerpos del sistema ABO. Esto evidencia la necesidad de esta prueba para reducir las reacciones post-transfusionales.


Abstract Introduction: Alloimmunization occurs between 1.0-1.5 % of people exposed to an external antigen or during pregnancy, a transplant or transfusion. In the blood banks, the screening of irregular antibodies different from those of the ABO system is performed. Objective: To estimate the prevalence of irregular antibodies in donors of a blood in Medellin 2016-2018. Methods: Cross-sectional study in 25 391 donors. Control of selection and information bias was carried out by applying techniques with excellent validity and internal and external quality control, and detection by ID-card Liss / coombs in six microtubes with anti-IgG and anti-C3d. The analysis was based on measures of summary, frequencies, chi-square and Fisher's exact. Results: The average age was 34 years. The prevalence of irregular antibodies was 0.30%, being higher anti-D with 0.071%. No statistical differences were found according to sex and age group; Anti-D was more frequent in women and donors aged 31-40 years. Conclusion: A high prevalence of Anti-D and Anti-Kell was found, which are of great clinical importance after the antibodies of the ABO system. This demonstrates the need for this test to reduce post-transfusion reactions.

3.
Journal of Medical Postgraduates ; (12): 272-275, 2016.
Article in Chinese | WPRIM | ID: wpr-487219

ABSTRACT

Objective Irregular antibody screening and identification are very important to reduce hemolytic reaction.The dis-tribution of irregular antibodies of blood group was analyzed in patients, to provide evidence for using Micro column gel test to detect and identify irregular antibodies transfusion safety. Methods Micro column gel anti-globulin technique was used to screen the irregular an-tibodies and cross-matching in 29770 patients.If the serum had irregular antibodies, the spectrum cells were used to identify the specific-ity of irregular antibodies. Results Among 29 770 patients, 120 cases had irregular antibodies of blood group.The positive rate was 0.4%.The irregular antibodies include Rh system(n=67),MNS system (n=7), Lewis system(n=5),cases of Kidd system(n=3) and undefined specified antibodies(n=38).Among the 120 antibody-positive patients, 70 were female patients and 50 were male patients. Further study showed that the pregnancy history was to the main factor causing irregular antibodies in women (46 positive cases among 70 female patients) . Conclusion The study showed that some patients had irregular antibodies of blood group, especially female patients with pregnancy history.These results suggested that irregular antibody screening and cross-matching by micro column gel method in pa-tients before transfusion had great significance for ensuring the blood transfusion safety.

4.
Rev. chil. obstet. ginecol ; 79(4): 315-322, 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-724833

ABSTRACT

La isoinmunización eritrocitaria feto-materna se define como la presencia de anticuerpos maternos dirigidos contra antígenos presentes en los glóbulos rojos fetales. Los anticuerpos maternos pueden atravesar la barrera placentaria y provocar hemólisis de los glóbulos rojos fetales produciendo anemia hemolítica e hiperbilirrubinemia, características de la enfermedad hemolítica perinatal (EHP). La principal causa de EHP es la incompatibilidad ABO, seguida de la isoinmunización por RhD; esta última ha disminuido su incidencia dado el amplio uso de inmunoglobulina anti D. Sin embargo, el glóbulo rojo tiene más de 400 antígenos, muchos de ellos (>50) capaces de producir isoinmunización y EHP. En este artículo, revisamos la evidencia y proponemos un algoritmo de manejo y seguimiento de las embarazadas con isoinmunización por anticuerpos irregulares. En la isoinmunización por anticuerpos irregulares, los títulos de anticuerpos maternos no se correlacionan con la gravedad de la enfermedad. La anemia en la EHP por anticuerpos anti-Kell es secundaria a una supresión de la eritroblastosis fetal a diferencia del resto de los sistemas que producen anemia hemolítica. Recomendamos efectuar tamizaje de todas las pacientes en el control prenatal, solicitando grupo sanguíneo, Rh y test de Coombs indirecto. En las pacientes Rh (+) con test de Coombs indirecto positivo es necesario identificar los anticuerpos irregulares. En caso de tener isoinmunización por anticuerpos irregulares con riesgo de EHP, derivar a una unidad de alto riesgo obstétrico para realizar seguimiento de la aparición de anemia fetal midiendo de modo seriado el peak sistólico de la arteria cerebral media. Si se detecta anemia fetal, debemos planificar una cordocentesis para confirmar el diagnóstico y tratar la anemia.


The fetomaternal erythrocyte isoimmunization is defined as the presence of maternal antibodies directed against antigens present in fetal red blood cells. Maternal antibodies can cross the placenta and cause hemolysis of fetal red blood cells causing hyperbilirubinemia and hemolytic anemia, known as perinatal hemolytic disease (PHD). The main cause of PHD is ABO incompatibility, followed by RhD isoimmunization. The latter has decreased its incidence since the widespread use of anti-D immunoglobulin. However, the red cell has more than 400 antigens; many of them (>50) can lead to isoimmunization and PHD. In this article, we review the evidence and propose an algorithm for the management and monitoring of pregnant women with irregular antibodies isoimmunization. In the isoimmunization by irregular antibodies, maternal antibody titers do not correlate with the severity of the disease. Anemia in PHD by anti-Kell is secondary to suppression of fetal erythroblastosis unlike other systems that produce hemolytic anemia. We suggest the screening of all patients in the prenatal control with blood group, Rh and indirect Coombs test. In the Rh (+) patients with positive indirect Coombs test, irregular antibodies should be identified. In case of immunization by irregular antibodies in risk of PHD, the women should be referred to a high-risk obstetrics where the appearance of fetal anemia should be seek by measuring systolic peak of middle cerebral artery. If anemia is detected full confirmation of diagnosis and treatment should be effected by cordocentesis.


Subject(s)
Humans , Female , Pregnancy , Erythroblastosis, Fetal/diagnosis , Erythroblastosis, Fetal/therapy , Rh Isoimmunization/diagnosis , Rh Isoimmunization/therapy , Severity of Illness Index
5.
Anesthesia and Pain Medicine ; : 40-42, 2009.
Article in Korean | WPRIM | ID: wpr-24142

ABSTRACT

Irregular or unexpected antibodies are alloantibodies against serum or red blood cells after previous exposure to transfusion. When encountered in critical condition, however, risk of ongoing complication is not entirely predictable. Rapid transfusion of safe blood is thus, crucial not to compromise further procedure. A 78-year-old ASA IV man presented with Hunt-Hess grade IV subarachnoid hemorrhage with huge temporal bleeds. While in operating room, his blood pressure dropped when the dura was opened. Meanwhile, routine screening of blood typing repeatedly denoted Rh+O with irregular antibodies. Soon, compatible cross-matched blood was infused with 37 degrees C normal saline 200 ml at a rate of 4-5 ml/kg/hr. There was no laboratory evidence of hemolytic transfusion reaction. Postoperatively, BUN and creatinine increased slightly, but urination and respiration were unremarkable.


Subject(s)
Aged , Humans , Antibodies , Blood Group Incompatibility , Blood Grouping and Crossmatching , Blood Pressure , Creatinine , Emergencies , Erythrocytes , Isoantibodies , Mass Screening , Operating Rooms , Respiration , Subarachnoid Hemorrhage , Urination
6.
Rev. cienc. salud ; 12(1): 7-13, dic. 2008. tab, graf
Article in Spanish | LILACS | ID: lil-567040

ABSTRACT

In the last years, the medicine transfusional has generated big advances in the area of the conservation and managing of the blood fractions, especially in the detection of incompatibilities between donors and recipients, using monoclonal antibodies powerful and new methods that detect antibodies in very low concentrations. The majority of the blood banks agree to provide compatible blood for the antigens ABO and Rho (D), because opposite to them the antibodies produce the more severe transfusional reactions. Nevertheless, there are many reactions that seemingly slip by for the clinical one in 4 hours later to the transfusion, period in which a narrower alertness is had in the patient. These antibodies (irregular antibodies) involved in many late reactions are capable of haemolyse red cells incompatible after 12, 24 or up to 72 hours of realized the transfusion, causing the death to the patient when the haemolysis is intravascular, without its manages to suspect that the reason was a reaction transfusional. This work had as general aim detect and identify the presence of irregular antibodies in samples tried of recipients and donors of the Bank of Blood of the Regional Hospital of Antofagasta, proving that the major number corresponded to the system Kell, with an incident of 25.42% of the Anti K O positive, 16.95% of the Anti K A positive.


En los últimos años, la medicina transfusional ha generado grandes avances en el área de la conservación y manejo de las fracciones sanguíneas, especialmente en la detección de icompatibidades entre donantes y receptores, utilizando antisueros monoclonales potentes y nuevos métodos que detectan anticuerpo concentraciones muy bajas. La mayoría de bancos de sangre se conforman, con proporcionar sangre compatible para los antígenos ABO y (D), porque frente a ellos los anticuerpos producen las reacciones transfusionales más severas. Sin embargo, hay muchas reacciones que aparentemente pasan inadvertidas para el clínico en las 4 horas posteriores a la transfusión, período en el que se tiene una vigilancia más estrecha en el paciente. Estos anticuerpos (anticuerpos irregulares) implicados en muchas reacciones tardías son capaces de hemolizar eritrocito es incompatibles después de 12, 24 o hasta 72 horas de realizada la transfusión, ocasionando la muerte al paciente cuando la hemólisis es intravascular, sin que se llegue a sospechar que la causa fue una reacción transfusional. Este trabajo tuvo como objetivo general detectar e identificar la presencia de anticuerpos irregulares en muestras procesadas de receptores y donantes del Banco de Sangre del Hospital Regional de Antofagasta, resultando que el mayor número correspondió al sistema Kell, con una incidencia de 25,42% del Anti K O positivo, 16,95% del Anti K A positivo.


Subject(s)
Humans , Male , Adolescent , Adult , Female , Infant, Newborn , Infant , Child, Preschool , Child , Middle Aged , Aged, 80 and over , Antibodies/blood , Blood Donors , Antibody Diversity/immunology , Mass Screening , Age and Sex Distribution , Antibody Specificity , Blood Group Antigens/immunology , Blood Group Antigens/blood , Chile/epidemiology , Erythrocytes/immunology , Isoantigens/immunology , Isoantigens/blood , Serologic Tests
7.
Rev. bras. hematol. hemoter ; 30(4): 272-276, jul.-ago. 2008. tab
Article in Portuguese | LILACS | ID: lil-496238

ABSTRACT

A fenotipagem eritrocitária pré-transfusional é um importante procedimento para aumentar a segurança das transfusões sangüíneas, sendo realizada rotineiramente no Hemocentro Regional de Uberaba-MG (HRU) desde 1996. O presente trabalho tem como objetivo geral avaliar a freqüência de anticorpos antieritrocitários irregulares em politransfundidos, de 1997 a 2005. Através de estudo retrospectivo foram levantados dados no arquivo do HRU de todos os pacientes aloimunizados, realizou-se análise estatística descritiva e comparam-se as proporções pelo teste "Z". Dos 23.220 transfundidos no período, com média de 5,7 transfusões por paciente, observou-se a ocorrência de aloimunização em 173 (0,75 por cento). Os sistemas Rh e Kell juntos tiveram freqüência superior a 70 por cento. A proporção do anti-D foi significativamente maior nas mulheres (p<0,05) e não houve diferença no sistema Rh entre brancos e não-brancos. Quanto à faixa etária, 70 por cento tinham mais de 30 anos. Dos 73 pacientes que tiveram a doença de base registrada, 39,73 por cento eram portadores de anemias agudas, 31,51 por cento de anemias crônicas e 28,77 por cento de doenças oncológicas ou onco-hematológicas. Aproximadamente 70 por cento dos anticorpos foram identificados até a décima transfusão. A baixa ocorrência da aloimunização no HRU reforça a importância da fenotipagem eritrocitária para todos os pacientes dependentes de transfusões crônicas, bem como da sua implantação na rotina de todos os serviços de hemoterapia.


Testing of the pre-transfusional blood phenotype, which has been carried out at the Regional Blood Bank in Uberaba since 1996, is an important procedure to improve safety of blood transfusions. This study aims to describe the frequency of irregular red blood cell antibodies in multiple-transfused patients from 1997 to 2005. In a retrospective study, data from all alloimmunized patients were collected from the blood bank files. Descriptive statistical analysis was performed and a comparison of proportions was made using the Z test. Alloimmunization was observed in 173 (0.75 percent) of the 23,220 transfused patients, with an average of 5.7 transfusions per patient. The frequency of the Rh and Kell systems jointly was over 70 percent. The proportion of anti-D was significantly higher in women (p<0.05) and no difference was noted in the Rh system between Caucasians and non-Caucasians. Seventy percent (70 percent) of the patients were over 30 years of age. Out of the 73 patients with registered diseases, 39.73 percent had acute anemias, 31.51 percent chronic anemias and 28.77 percent oncological or onco-hematologic diseases. Approximately 70 percent of antibodies were discovered before the 10th transfusion. The low frequency of alloimmunization observed at the Regional Blood Bank of Uberaba reinforces the importance of pre-transfusional blood phenotype screening for all multiple-transfused patients as well as its adoption as a common practice in all hemotherapy center.


Subject(s)
Humans , Antibodies/analysis , Antibodies/blood , Blood Transfusion , Antibody Diversity/immunology , Erythrocytes/immunology
8.
Korean Journal of Blood Transfusion ; : 39-47, 1997.
Article in Korean | WPRIM | ID: wpr-195276

ABSTRACT

BACKGROUND: Antibody screening for donated blood is not yet being performed in Korea. Positive rate of irregular antibodies in Korean patients or blood donors has been thought to be much lower than that of foreign contries. We studied to know the actual frequency of irregular antibodies in blood donors with history of parturition using gel card, which was recently introduced in the field of blood banking and considered to be easy to standardize and sensitive to detect irregular antibodies. METHODS: 706 samples were collected from four blood centers in Seoul for 4 months. Antibody screening and identification were done by two kinds of Gel Card (DiaMed-ID corp, DiaMed, Murten, Switzerland) such as Nacl/Enzyme and LISS/Coombs' card. Adsorption- elution test was done in samples of which we could know the antibody specificity. RESULTS: Irregular antibodies were identified in 24 cases among 706 samples, therefore the overall frequency was 3.4% (95% CI: 3.4% +/- 1.3%). Only 4 cases, however, showed positive reaction in both enzyme and Coombs' phase, therefore frequency of clinically significant antibodies was 0.57% (95% CI: 0.57% +/- 0.55%). The identified irregular antibodies were anti-Lea (8 cases), Anti-Rh (3 cases) and Anti-P1 (1 case). Adsorption-elution test showed positive reaction only in 3 cases with anti-Rh antibodies. CONCLUSION: Considering that blood donors with history of parturition comprize just little proportion of total donors in Korea and frequency of irregular antibody is relatively lower than that of foreign countries in same group (0.57% vs 3.8%), it can be concluded that antibody screening be not urgent problem in Korean blood donation program.


Subject(s)
Female , Humans , Antibodies , Antibody Specificity , Blood Banks , Blood Donors , Korea , Mass Screening , Parturition , Seoul , Tissue Donors
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