ABSTRACT
【Objective】 To analyze the effect of blood component transfusion when the results of direct antiglobulin test (DAT) changed from negative to positive after blood transfusion. 【Methods】 The data of 215 surgical blood recipients, who were admitted in our hospital from January to October 2019 and presented negative results for both DAT and irregular antibody screening (Anti-screening), were collected via Ruimei Laboratory Management System. DAT and Anti-screening were performed again after blood transfusion, and DAT positive patients(re-test positive group) were then subject to antibody classification and polybrene cross-matching (referred to as cross-matching), and Anti-screening positive patients were tested for irregular antibodies. Patients were stratified by perioperative RBCs transfusion volume as ≤4 U (150 ± 10% mL/U), >4 to 8 U and > 8 U, and DAT-negative patients after blood transfusion were set as the controls, and the transfusion effect of DAT-positive patients after blood transfusion was compared with them. 【Results】 8.84% (19/215) of DAT-negative patients turned positive after RBCs transfusion, among which IgG type accounted for 84.21% (16/19) and IgG+ C3 15.79% ( 3/19); two patients(anti-E and-M, 10.53%) were positive in anti-screening re-test and the rest were negative (89.47%, 17/19). As for cross matching, incompatibility of both primary and secondary side, primary side and secondary side accounted for 5.26% (1/19), 5.26% (1/19) and 10.52 (2/19), respectively, while 78.95% (15/19) showed compatibility of both primary and secondary side. The Hb, RBC and Hct values of the re-test positive group, received RBC transfusion volume (U)≤4 and >4~8, were effectively elevated compared with the controls (P8 U(P>0.05). 【Conclusion】 The conversion of DAT negative results to positive after RBC transfusion indicates the patient has developed antibodies or the incidence of blood transfusion reaction, which can provide references for the clinical choice of appropriate blood components to ensure the safety and effectiveness of blood transfusion.
ABSTRACT
Objective To evaluate the effect of infusion of fresh or old red cell suspension and different volume of blood transfusion on the prognosis of patients with surgical.Methods Totally 273 patients undergoing the first elective orthopedic surgery from the first af-filiated hospital of Xinjiang medical university from January 2013 to December were enroued.Accepting criteria induded 15-65years ,no limitation for race and gender, ASAⅠ-Ⅲgrade, need of transfusion of red blood cell≤10U.According to the oldest storage age of any RBCs transfused:patients who received only RBCs stored for≤14 days were grouped to the Fresh, those who only RBCs stored for >14 days were grouped to the Old.According to the volume of blood transfusion were divided into ≤2U, 3 -4U, ≥5U three groups. Record The demographic and clinical features of the patients were recorded and length hospital stay, the rate of ICU shift, pulmonary in-fection occurred, postoperative transfusion rate, incision healing condition and major adverse cardiovascular events of to compared two groups.Results There was statistical differences in postoperative 24h hemoglobin , postoperative transfusion rate, pulmonary infection occurred and major adverse cardiovascular events between the Fresh and Old group ( P<0.05) .A trend of increasing complication rate was observed with more units transfused, especially≥5U.Conclusion Infusion of old red cell suspension has a certain impact on the surgery patients′postoperative complications.The volume of blood transfusion is consistently associated with adverse outcome.