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【Objective】 To investigate the differential diagnosis of 1 anti-C, e alloantibodies combined with anti-e, Jkb mimicking alloantibodies by absorption-elution test and titer integral method. 【Methods】 ABO, Rh and Kidd blood group antigens were identified by tube method. Two sets of panel cells were used for antibody screening and antibody specificity identification by saline method, polyamine method and microcolumn gel method.The antibody was further confirmed by multiple absorption-elution tests and titer integral method. RHCE and JK gene were sequenced by multiple PCR. 【Results】 Serological gene sequencing analysis showed that the ABO blood group of the patient was A type with Rh subtype ccDEE and was positive for direct antiglobulin test (DAT). Multiple absorption-elution tests and titer integral method demonstrated that the serum of the patient contained anti-C, e alloantibodies along with anti-e, Jkb mimicking autoantibodies and there were anti-e, Jkb mimicking autoantibodies on red blood cells(RBCs). According to gene sequencing analysis, there was G>C at exon 676 of the RHCE gene, and the remaining exons were not mutated, suggesting that the RHCE phenotype was ccEE. The 838 G/A heterozygote of exon 9 in JK gene, Jk blood group phenotype was Jk (a+ b+ ). Cross matched type A ccDEE and Jk(a+ b-) RBCs were transfused, and no adverse reactions occurred. 【Conclusion】 Serology combined with molecular biology to identify the phenotype of the patient′s RBCs, absorption-elution test and titer integral method to identify the antibody of the patient′s serum can detect the alloantibody type, thus providing strategies for targeted blood transfusion.
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【Objective】 To retrospectively analyze the characteristics of blood transfusion compatibility detection in patients with delayed serologic transfusion reaction ( DSTR), in order to provide reference for safe and effective blood transfusion in clinical practice. 【Methods】 From April 2020 to July 2021, 6 samples of patients who applied for blood type identification, unexpected antibody screening and transfusion from the Third People′s Hospital of Chengdu or People′s Hospital of Sichuan Province were collected. Microcolumn method was used for identification of ABO and RhD blood type of patients; unexpected antibody screening, blood cross-match, antibody identification and direct anti-human globulin tests were also conducted. The sensitizing antibodies on the surface of red blood cells were identified by acid release solution, and the antigen-antibody reaction was enhanced by polyethylene glycol. The patients′ own red blood cells and input red blood cells were separated by capillary high-speed centrifugation, and the surface antigens of red blood cells were detected by serological method. Meanwhile,the characteristics of patients before and after transfusing antigen-positive red blood cells were summarized. 【Results】 Anti-E was detected in the plasma of patients 1 and 2, and anti-c,-E were detected in the red blood cell release solution, while anti-C, anti-E, anti-JKa and anti-Fyb were detected in the plasma and red blood cell release solution of patients 3, 4, 5 and 6, respectively. After capillary high-speed centrifugation, antigen-positive red blood cells were detected in the distal end of the blood samples of 6 patients. 【Conclusion】 For patients with multiple blood transfusions and a recent history of blood transfusion, when newly emerging erythrocyte antibodies with clinically significance, direct anti-human globulin test(+) or erythrocyte antibody screening(+) are detected, and the patient has no clinical symptoms of hemolysis, it should be suspected as DSTR occurrence, and the transfusion reaction investigation procedure should be initiated in time.
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【Objective】 To evaluate the detection and distribution characteristics of anti-P1 in tumor patients, so as to aid in blood screening and transfusion safety. 【Methods】 The clinical data of 112 658 tumor patients who underwent blood preparation and transfusion in our hospital from January 2014 to December 2021 were retrospectively analyzed, and column agglutination technique was used to perform transfusion compatibility test. 【Results】 A total of 1 079 (0.96%, 1 079/112 658) cases were detected with unexpected antibodies, of which 71 (6.58%, 71/1 079) were identified as anti-P1. In anti-P1 cases, 59.15% (42/71) were males; 60.56% had no pregnancy history (P<0.01); 29.58% (21/71), 52.11%(37/71), 12.68%(9/71) and 5.63%(4/71) of anti-P1 patients were with type A, B, O and AB, respectively. 57 cases of anti-P1 patients (80.28%) had difficulty in ABO blood group identification. The incidence of interfering in patients with type B was higher than that of other blood types (P<0.05), as the frequency of w+ in reverse blood typing was higher than other reactive patterns (P<0.05). The incidence of gastric tumor and brain space-occupying lesion in patients with anti-P1 was higher than that in patients with other alloantibodies, while the incidence of gynecological tumors was lower (P<0.05). 【Conclusion】 Anti-P1 affects the ABO blood group identification of tumor patients, and most of them had difficulty in ABO blood group identification. Compared with patients with other alloantibodies, patients with anti-P1 are more likely to be male and suffer from gastric and brain tumors, but less likely from gynecological tumors.
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【Objective】 To analyze the yield, specificity and detection time of red blood cell(RBC)alloimmunization in 104 588 inpatients. 【Methods】 The clinical information of patients who underwent at least one antibody screening in our hospital from November 2017 to December 2019 was retrospectively analyzed. The demographic characteristics, transfusion history, pregnancy history and antibody screening results of patients were collected. The RBC alloantibody yield, specificity and detection time were analyzed, and differences of transfusion units and frequency between patients with and without alloimmunization were compared. 【Results】 Eight hundred cases of alloantibodies with clinical significance were detected in blood samples of 723 patients, with a positive rate of 0.7% (723/104 588). The incidence rate of alloimmunization in females was higher than that in males (0.9% vs 0.5%, P<0.05). Rh alloantibodies accounted for 76.4%(611/800), of which 61.4%(375/611)were anti-E. Transfusion units and frequency of patients with alloimmunity were higher than those without(median: 6.0 vs 4.0, P<0.05; 4.0 vs 2.0, P<0.05, respectively). And 67.5% of RBC alloantibodies were detected within 6 months, with the median (IQR) detection time of 97.0 (22.5-247.0) days. 【Conclusion】 Routine antibody screening should be performed before transfusion in order to reduce the occurrence of adverse reactions, and Rh typing transfusion with compatible crossmatch should be performed if necessary.
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Blood transfusion, an important auxiliary means of clinical treatment, however, is not absolutely safe and risk-free as the transfusion-associated RBC alloantibodies being a potential risk. The yielding rate of RBC alloantibodies in Chinese Han population is about 0.2%, and the researches concerning its production mechanism is particularly critical due to its important clinical significance in patients′ future blood transfusion or pregnancy. This paper reviews the current research status of red blood cell alloantibodies associated with blood transfusion and its susceptibility factors.
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【Objective】 To investigate treatments of discrepancy presented in blood typing and cross-matching test caused by anti-I antibody and the difference between autoanti-I antibody and alloanti-I antibody. 【Methods】 38 cases of I-positive antibody in our hospital from January 2016 to July 2019 were selected as the research subjects. The irregular antibodies screening and identification were performed by adopting the anti-human globulin and saline test tube method, and the blood transfusion effect was evaluated. 【Results】 37 cases of autoanti-I antibody and 1 case of alloanti-I antibody, with specificity produced by an individual with a rare i blood group, were identified. 34 cases contained I-positive antibody and 4 contained I-positive antibody combined with alloantibodies. At 4 ℃, most of the anti-I titers were between 32 and 512, 2 cases were more than 1 024. After the RBCs were washed with 37℃ normal saline and cold absorbed at 4℃, the cross-matching tests were matched and 37 cases of blood transfusion were all effective except for one case. After performing the same treatment on i adult red blood cells and adding I antigen-negative cord blood cells, the result was correct to be B type. The titer of IgM alloanti-I antibody in this adult was 256, and autotransfusion was preferred. 【Conclusion】 Patients with anti-I antibody, reactive at low temperature, should be treated with warm and slow transfusion under close monitoring. Autotransfusion is, in principle, beneficial to adult i blood group patients producing alloanti-I antibody. If i blood patients suffered from massive blood loss without suitable blood resource available, the elderly i blood donors were preferred, and plasmapheresis may also be an alternative to remove anti-I temporarily.
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【Objective】 To analyze the blood samples sent by hospitals in Shenzhen to solve ABO cross-match incompatibility during 2011 to 2020, so as to find corresponding solutions to improve the efficacy of blood transfusion. 【Methods】 The clinical data of 1 770 cases of cross-match incompatibility in our laboratory from January 2011 to December 2020 were collected and reviewed. The causes of cross-match incompatibility were analyzed, the types of unexpected antibodies were determined. The overall incidence of antibodies was evaluated by statistical method of classified variables. The safety of blood transfusion was safeguarded by ABO homotype plus cross-matching compatibility. 【Results】 1) The 1 770 samples, presenting cross-matching incompatibility, involved 956 patients. The average number of cross-matching per patient from 2011 to 2015 was 1.32(307/232), which increased from 1.27(103/81) in 2016 to 2.23(286/128) in 2018, and remained stable in 2019 and 2020. 2) Among 956 patients, auto-and/or allo-antibody in plasma were yielded in 90.38%(864/956), including auto-antibody plus alloantibody in 42.26%(404/956), solo auto-antibody in 20.71%(198/956) and solo allo-antibody in 27.41%(262/956). Up to 20 kinds of specific allo-antibodies were detected, belonging to 8 blood groups. Among them, 70.82%(551/778) were Rh blood group, such as anti-E(37.15%)>anti-c(20.95%)>anti-C(5.27%)=anti-e(5.27%)>anti-D(2.19%), followed by MNS [11.40%(112/778)], Kidd [5.66%(44/778)], Leiws [3.21%(25/778)], Duffy [1.80%(14/778)], Diego [1.03%(8/778)], P1 [0.39%(3/778)] and H [0.26%(2/778)]. 3) 86%(37/43) of multiple transfusion recipients, aged below 20 years old, were thalassemia, and 1-4 kinds of allo- and/or auto-antibody were yielded. 【Conclusion】 The cross-matching incompatibility were mainly caused by allo- and/or auto-antibodies, which may be induced by blood transfusion, pregnancy or autoimmune diseases such as autoimmune hemolytic anemia.Those suspicious blood samples in clinical should be sent to blood group reference laboratory for further determination, in order to ensure the safety and efficacy of blood transfusion.
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【Objective】 To explore a simple method to remove the interference of monoclonal anti-CD38 from compatibility testing and evaluate its effectiveness and safety, in order to develop a reasonable clinical transfusion strategy. 【Methods】 Blood phenotype detection, direct antiglobulin testing(DAT) and antibody screening were carried out by standard methods. Antibody screening and cross-matching of serums after monoclonal anti-CD38 treatment were performed by anti-human globulin card with 0.2 mol/L or 0.04 mol/L dithiothreitol(DTT) treated red blood cells. 【Results】 The results showed that 0.04 mol/L DTT treated directly in the anti-human globulin card for 15 min can completely remove the interference of monoclonal anti-CD38 in antibody screening and cross-matching without compromising of the yielding of anti-K, anti-LW, anti-JMH and anti-Lub alloantibodies. However, the titer of IgM antibodies may decrease in different degrees, and antibody screening and cross-matching with saline methods are required to avoid the missed detection of IgM alloantibodies. All 12 patients had no acute or delayed haemolytic transfusion reactions and their routine blood tests showed that the red blood cells transfusion were effective. 【Conclusion】 Based on antibody screening and cross-matching plus saline method, the method of 0.04 mol/L DTT, treated directly in the anti-human globulin card, is safe, effective and simple, which can detect most alloantibodies.
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【Objective】 To investigate the effect of serological methods for eliminating the interference of warm autoantibodies with the compatibility test before blood transfusion. 【Methods】 The blood samples (whole blood and serum, 3 mL/each) of 10 cases of warm autoantibodies interfering with antibody screening and identification were collected. Autogenous or allogeneic red blood cells(RBCs) were treated with microthermal(45 ℃), chloroquine, or ZZAP (dithiothreitol and papain) reagents, and then were used to absorb the autoantibodies in patients′ plasma. The plasma after absorption and RBC elution were used for antibody identification by anti-human globulin method or Polybrene method to determine the specificity of the autoantibody/alloantibody. Blood transfusion with ABO/Rh homotypic RBCs without corresponding antigens was performed in patients with alloantibodies or specific autoantibodies, and the efficacy of blood transfusion was evaluated. 【Results】 The interferenc of warm autoantibodies with antibody screening and identification due to primary or secondary autoimmune diseases were eliminated after absorption, and IgG isospecific antibodies (anti-E, anti-Jka, anti-Wra) in 3 cases and specific autoantibodies (anti-Ce) in 1 case were yielded. 6 of the 10 patients received blood transfusion, and 4 with specific antibodies avoided exposure to corresponding antigens. After transfusion of 2U suspended RBCs, the increase of hemoglobin at 24h in all 6 patients was greater than 10 g/L, and no hemolytic transfusion reaction occurred. Anemia symptoms were improved after transfusion. 【Conclusion】 Appropriate elution methods and autologous/allogeneic absorption methods can eliminate the interference of warm autoantibodies with the identification of alloantibodies, therefore can accurately identify the types and properties of antibodies, thus providing targeted and effective blood transfusion.
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【Objective】 To develop a novel solid-phase agglutination reagent for detecting IgG irregular antibodies of red cell blood groups and evaluate its performance. 【Methods】 Monoclonal anti-RBC antibody was coated on the bottom of the microwell strips, then RBCs were bonded to the antibody and formed the monolayer by dispensing 100 μL RBC suspesion to microwell strips.RBC antigen membrane monolayer was formed by lysing RBC layer with ddH2O, then the drying medium was added to the strips and dried under reduce pressure in a vacuum dryer, thus the dried reagent microplate was obtained.Serial diluted solutions of polyclonal sheep anti-human globulin(IgG+ C3d/4)was used to react with IgG anti-D sensitized O group RBCs to select out the best indicator.Stability of membrane antigen was tested by detecting IgG anti-D and anti-E with the lowest titer by different batches of regeats. Sensitivity of the novel reagent, Capture-R Ready Screen and microcolumn gel card was carried out by detecting irregular antibodies with different titer.350 plasma samples were tested by the novel reagent and Capture-R Ready Screen to evaluate their detection ability. 【Results】 Anti-RBC solution with concentration of 20 μg/mL could fix the membrane monolayer very well on the bottom of microstrips. Sixteentimes dilution of polyclonal sheep anti-human globulin and anti-D sensitized RBCs were selected out as the best indicator.Antigen reactivity of dried RBC membrane was not weakened during the 6-monthstorage period.Sensitivity of the novel reagent was higher than Capture-R Ready Screen and microcolumn gel card. The positive consistence ratio of the novel reagent and Capture-R Ready Screen was 98.0%, the negative consistence ratio was 99.66%, and the total consistence ratio was 99.43%. 【Conclusion】 A novel solid-phase agglutination reagent with higher sensitivity and longer storage time has been developed successfully and it has an equal detection ability compared with Capture-R Ready Screen for detecting irregular alloantibodies of red cell blood groups.
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Lung transplantation is increasingly practiced for patients with end-stage lung disease. The successful outcome of solid organ transplantation today is severely impeded by the production of alloantibodies, mainly directed against the protein products of the HLA complex of the organ donor. While the association between antibody mediated rejection and allograft damage has been well established in renal and heart transplantation, it has not yet been well characterized in lung transplantation. This review addresses the question of HLA matching in lung transplantation and current knowledge of the allogenicity of different HLA class I and II antigens. The role of the antibody mediated immune response is discussed as well as the importance of pre-transplant or de novo post-transplant circulating antibodies. Finally, potential mechanisms, which may act individually or in combination, of antibody mediated damage to solid organ transplants are considered.
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Antibodies to high-incidence red blood cell antigens should be considered if panagglutination reactions are noted in all panel cells, and negative reactions to autologous red blood cells are detected on antibody screening and identification tests. In Korea, most of those antibodies are identified through international reference laboratories. To prevent a hemolytic transfusion reaction, antigen-negative red cells should be provided for those patients who have antibodies to red cell antigens. However, this is nearly impossible when the antibody has specificity to high-incidence red cell antigen. In those cases, transfusion of autologous blood, cryopreserved rare blood and the least incompatible blood components can be considered. In the case of surgery, acute normovolemic hemodilution or intraoperative blood salvage can also be considered. For the patients who have antibodies to high-incidence red cell antigens, it should be discussed to set up a national reference laboratory to quickly identify antibody specificities, and to consider establishing rare blood donor registry and frozen rare blood storage/supply system. This article reviews characteristics of antibodies to high-incidence antigens found in Koreans and also the transfusion experiences of those patients based on literature.
Subject(s)
Humans , Antibodies , Antibody Specificity , Blood Donors , Erythrocytes , Hemodilution , Isoantibodies , Korea , Mass Screening , Operative Blood Salvage , Sensitivity and Specificity , Transfusion ReactionABSTRACT
A 72-year-old man with general weakness visited the outpatient clinic of the hematology department. The patient had been treated under the diagnosis of autoimmune hemolytic anemia for 2 years. His hemoglobin level at the time of the visit was 6.3 g/dL, and a blood transfusion was requested to treat his anemia. The patient's blood type was A, RhD positive. Antibody screening and identification test showed agglutination in all reagent cells with a positive reaction to autologous red blood cells (RBCs). He had a prior transfusion history with three least incompatible RBCs. The patient returned home after receiving one unit of leukoreduced filtered RBC, which was the least incompatible blood in the crossmatching test. After approximately five hours, however, fever, chills, dyspnea, abdominal pain, and hematuria appeared and the patient returned to the emergency room next day after the transfusion. The anti-Fy(a) antibody, which was masked by the autoantibody, was identified after autoadsorption using polyethylene glycol. He was diagnosed with an acute hemolytic transfusion reaction due to anti-Fy(a) that had not been detected before the transfusion. In this setting, it is necessary to consider the identification of coexisting alloantibodies in patients with autoantibodies and to become more familiar with the method of autoantibody adsorption.
Subject(s)
Aged , Humans , Abdominal Pain , Adsorption , Agglutination , Ambulatory Care Facilities , Anemia , Anemia, Hemolytic, Autoimmune , Autoantibodies , Blood Transfusion , Chills , Diagnosis , Dyspnea , Emergency Service, Hospital , Erythrocytes , Fever , Hematology , Hematuria , Isoantibodies , Masks , Mass Screening , Methods , Polyethylene Glycols , Transfusion ReactionABSTRACT
Background & Objective: The recommended treatment for beta thalassemia major involves regular blood transfusions, whichstimulate the patient’s immune system and results in the formation of antierytrocyte antibodies usually IgG class. They can result in clinical hemolysis and complication of blood cross matching. The purpose of this study was to determine the frequency of RBC alloantibodies, the type of these antibodies, factors influencing on alloimmunization among multiple- transfused thalassemia major patients. Methodology: ABO blood grouping,Rh (D) typesand Phenotyping done by the electromagnetic technology using Qwalys 3 Diagast. Antibody screening was done by using 3-cell panel followed by11- cell panel of Biorad Corporation. Results: 10 patients developed alloantibodies against RBC Antigen. Among total alloimmunizedpatients, 7.35%were female and 4.27% were male. Majority of alloantibodies were directed against antigen in the Rh and Kell system. i. e. Anti c, Anti E and Anti K. Frequency of Alloantibody positivism is maximum in AB positive patients. From extended Antigen typing of voluntary donors, we can see the frequency of D, C and e Antigens are more than frequency of c, E and K Antigens. Conclusion: Frequency of red cell alloimmunizationwas 5.40% in this study. Alloantibodies found were mainly against Rh blood group systemand Kell system. Red cell alloantibody formation was not influenced by age at first transfusion, number of blood transfusion, splenectomy and leuckodepleted blood transfusion. In our study alloimmunized patients did not revealed any evidence of haemolytic transfusion reaction. The frequency of Antibody positivity depends on immunogenicity of Antigen. Females and group AB patients are showing more frequency of alloimmunization. Routine pretransfusion matching of blood, other than ABO and RhD antigen is not recommended because of low rate of red cell alloimmunization and high cost associated with such testing.
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Objective:To investigate the expression of platelet-specific alloantibody in the sera of primipara,pluripara,and recurrent spontaneous abortion (RSA) patients,and analyze the relationship between platelet-specific alloantibody and gravidity or RSA. Methods:A total of 100 primipara, 100 pluripara (gravidity≥2) and 100 RSA patients who received prenatal examination in department of aristogenesis, No. 202 Hospital of PLA from Apr 2015 to Dec 2015 were recruited. The blood samples were collected during 16-28 weeks of pregnancy, and the expression of platelet-specific alloantibody was detected by solid-phase red cell adherence assay. Results:There were 5 positive platelet-specific alloantibody in primipara group, 14 in red all pluripara group,and 26 in RSA group. Platelet-specific alloantibody was significantly associated with gravidity and the incidence of RSA (P<0.05) by chi-square analysis. Conclusion:Screening the expression of platelet-specific alloantibody during pregnancy can provide evidence for the diagnosis and treatment of RSA.
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Objective To reduce the risk of blood transfusion ,and discuss the serological characteristic and cross‐match test of those patients who got positive both in autoantibody test and direct coombs test .Methods With absorption‐elution testing ,antibody screening cells and panel cells belong to different manufactures and batch numbers were applied to distinguish autoantibody from al‐loantibody within serum and reagent red cells for absorption test .Appropriate donors were selected to do cross matching test ;the specificity of autoantibody and alloantibody and the relationship between ABO blood type ,diseases ,anemic and the efficacy of blood transfusion were analysed .Results Among the 139 study subjects ,all of them were identified positive both in autoantibody and di‐rect antibody test ,including 20 cases just have autoantibody ,59 cases accompanied with Rh system or MNs system or Kidd system antibody ,47 with autoantibody except for alloantibody ,13 with drug resistant or other system antibody .Within the 221 cases of blood transfusion ,none of them has hemolytic transfusion reaction .We found a positive correlation(P0 .05) .Conclusion To those cases which were identified positive both in autoantibody and direct antibody test ,the degree of anaemia ,the numbers of transfusion and the efficacy of transfusion were associated with the intensity of agglutination of autoantibody and direct antibody .In order to de‐crease the risk of blood transfusion and make it highly efficient ,we should affirmed it if there is any autoantibody .In this process , an appropriate procedure and assay must be adopted .Besides ,relative antigen‐negative donors or high frequency local autoantibody need to be matched with corresponding the donors who have the same type of antigen .
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Introdução: Os anticorpos específicos contra o doador (DSA) representam uma das principais barreiras para o sucesso do transplante renal. Material e métodos: Os cem receptores, classificados em baixo risco (BR), médio risco (MR), alto risco (AR) e muito alto risco (MAR) de terem rejeição mediada por anticorpos (RMA) foram transplantados com rins de doadores falecidos (DF). A sobrevida dos enxertos foi avaliada após um ano. Resultados: Dos 100 receptores que receberam rins de DF, 54 (54,0%) foram classificados como BR. Destes, oito rejeitaram (14,8%), três perderam os enxertos, sendo duas perdas por RMA (DSA MFI 1223 a 2341) e uma por causa não imunológica (CNI). Entre os 30 (30,0%) classificados em MR, 10 (33,3%) rejeitaram, desses quatro perderam os enxertos, sendo duas perdas por RMA (DSA MFI 530 e 870), uma por rejeição celular (RC) e uma por CNI. Entre os 10 (10,0%) classificados em AR, três rejeitaram, sendo observadas três perdas por RMA (DSA MFI de 3493 a 6068). Entre os 6 (6,0%) classificados como MAR, cinco tiveram episódios de rejeições, quatro perderam os enxertos, sendo três perdas por RMA (DSA MFI 7226 a 12591) e uma por RC. A sobrevida dos enxertos no primeiro ano para os pacientes em BR, MR, AR+MAR foi de 91,22%, 78,75% e 80,28%, respectivamente. Conclusão: Esse protocolo demonstrou ser eficiente e permitiu uma avaliação imunológica precisa de receptores classificados de acordo com o risco de RMA. Do total de pacientes, 26 (26%) tiveram episódios de rejeições, 12 (46%) pacientes perderam os enxertos devido a causas imunológicas, sendo duas perdas por RC e 10 por RMA, o que evidencia a gravidade das rejeições. Além disso, tivemos duas perdas por CNI. Após um ano, 87 (87%) dos pacientes mantiveram boa função renal, com creatinina variando de 0,9 a 1,6 mg/dL...
Subject(s)
Humans , Male , Female , Transplantation , Kidney TransplantationABSTRACT
Lutheran a antigen (Lua) is detected in 6 to 8% of Caucasians and Africans. In Korean and other Asian populations, it is very rare or nearly absent. Therefore, although Lua has a considerable immunizing capacity, sensitization to Lua is a rare event. Here we report on a rare case of anti-Lua in a 70 year-old female patient with Lu (a-/b+) phenotype and review the relevant literature. Due to the paucity of Lua positive panel cells in antibody screening and identification tests, detection of this rare antibody to Lua antigen is not feasible. Therefore, we should keep in mind the possibility of the misleading false negative result in detection of antibody to this low incidence antigen.
Subject(s)
Female , Humans , Asian People , Incidence , Lutheran Blood-Group System , Mass Screening , Phenotype , ProtestantismABSTRACT
Objective To organize the 14th ISBT Platelet Immunology Workshop and Cooperative Research Project,and proficiency evaluation on the techniques and quality level of platelet alloantiboby analysis will be taken effect for the 42 platelet immunology laboratories around the world. Methods Organized and confirmed by Nanning Institute of Transfusion Medicine,9 quality control samples contained the Human Platelet Antigen (HPA) specificity antibody have been supplied to all the participated laboratories in this project. The participants could use the In-House technology or/and market kits to test these quality control samples. The forms and sheets have been provided for recording of results. Results There were 36 laboratories from 23 countries participated in this Cooperative Research Project,and 35 laboratories have reported their results. The appraised consistent rate of the 9 quality control samples ranges from 20% to 97.14%,the HPA antibody specificities have been showed as anti HPA-1a,anti HPA-1b,anti HPA-3a,anti HPA-3a,anti HPA-3b,anti HPA-5b,anti HPA-5a,anti GPIV and anti HPA-5b+15b,respectively. Among the appraised consistent rate,the anti HPA-3b were the lowest and the anti HPA-5b and anti HPA-5a was the highest. Over 10 technologies of platelet alloantiboby analysis were used by the laboratories. Conclusion This international cooperative research project has successfully made the proficiency evaluation and report on the techniques and quality level of platelet alloantiboby analysis for the 35 international platelet immunology laboratories.
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Posttransfusion purpura is a rare but potentially fatal disorder, characterized by the development of severe thrombocytopenia following transfusion. We report the first case of posttransfusion purpura in Korea in a 39-year-old multiparous woman. Nine days after transfusion of two units of red blood cells during cesarian section operation, she developed sudden onset of purpura, gum bleeding, and severe thrombocytopenia. Serological analysis revealed that the patient had antibodies against HPA-3a (Baka) and HLA. She was treated with plasmapheresis and the platelet count dramatically normalized. Though posttransfusion purpura is a self-limited disorder, early diagnosis and proper treatment can shorten the duration of the clinical course.