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Journal of Experimental Hematology ; (6): 1325-1329, 2021.
Article in Chinese | WPRIM | ID: wpr-888560


OBJECTIVE@#To explore the clinical application of screening cell combination method in the prediction of red blood cell alloantibody, so as to provide basis for clinical diagnosis.@*METHODS@#From October 2018 to April 2020, 9 680 samples were screened with automatic blood group instrument, 79 patients with positive alloantibodies were identified by 4 sets of screening cells from different manufacturers (referred to as combined method). At the same time, cell panel Panocell-16 was used for comparative analysis. Meanwhile, the combined method was also used to identify the antibodies of 20 samples from National Center for Clinical Laboratories external quality assessment (EQA) in China and 12 samples from WHO EQA.@*RESULTS@#The 79 alloantibodies included anti-Mia antibody (7 cases), anti-M antibody (13 cases), anti-Le@*CONCLUSION@#The combined method can identify the alloantibodies of red blood cells in Chinese population. The screening cells can be used for screening of irregular antibodies without wasting reagents at the same time.

Autoantibodies , Blood Group Antigens , China , Erythrocytes , Humans , Isoantibodies
Journal of Experimental Hematology ; (6): 1301-1307, 2021.
Article in Chinese | WPRIM | ID: wpr-888556


OBJECTIVE@#To understand the characteristics of patients with mimicking specificity autoantibodies through the analysis of the causes of autoantibodies, specificity of antibodies, strategy of blood transfusion, effect of transfusion and distribution of antibodies in China and abroad.@*METHODS@#A total of 23 patients who applied for blood in our hospital from January 2017 to June 2019 were identified as mimicking specificity autoantibodies by antibody identification or absorption-elution test. The causes of mimicking specificity autoantibodies, antibody specificity, blood transfusion strategy and blood transfusion effect were analyzed. The relevant articles on antibodies published in China and abroad were summarized and sorted out, and the distribution of antibodies was analyzed.@*RESULTS@#All the 23 patients with mimicking specificity autoantibodies were Rh blood group system antibodies, of which mimicking anti-Ce autoantibodies were the most common (34.8%), followed by mimicking anti-e autoantibodies (26.1%), mimicking anti-D autoantibodies (21.7%), mimicking anti-C autoantibodies (8.7%) and mimicking anti-E autoantibodies (8.7%). Except for 2 cases with suspected history of blood transfusion, the other 21 cases had a history of blood transfusion / pregnancy. The most common cause of mimicking autoantibodies was drug, followed by infection and autoimmune diseases. The hemoglobin (Hb) of pretransfusion in the blood transfusion group was (48.4±23.9) g/L, which was significantly lower than (86.0±38.9) g/L in the non-transfusion group (P<0.01). Except for 2 cases who could not evaluate the effect of blood transfusion, the effective rate of transfusion was 100%. According to the retrospective statistics of 32 related articles published in China and abroad, the most type of mimicking antibodies were in Rh blood group system, accounting for 79.28%, among which anti-E was the main part of all mimicking autoantibodies, accounting for 21.95%. The following ones were in Kidd system MNSs system, and Kell system.@*CONCLUSION@#Combined with the clinical symptoms and the degree of difficulty of blood matching, the best strategy of blood transfusion should be selected to ensure the safety of blood transfusion.

Autoantibodies , Blood Group Antigens , Blood Transfusion , Female , Humans , Isoantibodies , Pregnancy , Retrospective Studies
Article in Chinese | WPRIM | ID: wpr-880061


OBJECTIVE@#To establish quantitative surface plasmon resonance (SPR) assay for antibodies against human platelet antigen-1a (HPA-1a).@*METHODS@#Recombinant protein was fixed on the chip surface by amino coupling method. SPR assay was used to detect the standard antibodies against HPA-1a at different conceatration. The optimal experimental parameters were determined, and standard curves were constructed with linear regression. Moreover, the sensitivity, specificity, accuracy and precision of the assay were evaluated.@*RESULTS@#The quantitative SPR assay for HPA-1a antibodies was established. The determination ranges were 0-20 IU, with accuracy (recovery rate) was 97.75%-103.08%. The intra-assay precision [coefficients of variation (CV)] was 3.53%-4.29%, and the inter-assay precision (CV) was 2.08%-4.40%. For specificity test, several kinds of monoclonal and human antibodies against platelet membrane protein were tested and no positive result was observed.@*CONCLUSION@#The established quantitative SPR assay for HPA-1a antibodies shows good sensitivity, specificity, accuracy and precision, and this rapid and simple method provides a new reference method for scientific research and clinical antibody detection.

Antigens, Human Platelet , Blood Platelets , Humans , Isoantibodies , Surface Plasmon Resonance
Article in English | WPRIM | ID: wpr-922600


Antibody-mediated rejection (AMR) is a rare and serious complication after lung transplantation, with no characteristic of pathological manifestation, no systematic standard treatment, and the poor efficacy and prognosis. We reported a case of early AMR after lung transplantation and the relevant literature has been reviewed. A male patient presented with symptoms of cold 99 days after transplantation and resolved after symptomatic treatment. He admitted to the hospital 14 days later because of a sudden dyspnea and fever. Anti-bacteria, anti-fungi, anti-virus, and anti-pneumocystis carinii treatment were ineffective, and a dose of 1 000 mg methylprednisolone did not work too. The patient's condition deteriorated rapidly and tracheal intubation was done to maintain breathing. Serum panel reactive antibody and donor specific antibody showed postive in humen leukocyte antigen (HLA) II antibody. Pathological examination after transbronchial transplantation lung biopsy showed acute rejection. Clinical AMR was diagnosed combined the donor-specific antibody with the pathological result. The patient was functionally recovered after combined treatment with thymoglobuline, rituximab, plasmapheresis, and immunoglobulin. No chronic lung allograft dysfunction was found after 3 years follow up. We should alert the occurrence of AMR in lung transplantation recipient who admitted to hospital with a sudden dyspnea and fever while showed no effect after common anti-infection and anti-rejection treatment. Transbronchial transplantation lung biopsy and the presence of serum donor-specific antibody are helpful to the diagnosis. The treatment should be preemptive and a comprehensive approach should be adopted.

Graft Rejection , Graft Survival , HLA Antigens , Humans , Isoantibodies , Lung Transplantation/adverse effects , Male
Pesqui. vet. bras ; 41: e06654, 2021.
Article in English | LILACS, VETINDEX | ID: biblio-1180877


This study aimed to determine the erythrocyte phenotypes of the feline AB system and to check the presence of antigens other than those present in the feline AB system in domestic cats from Ilhéus-Itabuna microregion, Bahia, Brazil. Three-hundred feline blood samples were collected at the Veterinary Hospital of the "Universidade Estadual de Santa Cruz" (UESC) and in home visits to perform blood phenotyping using the tube-method testing. The reverse phenotyping was made between cats that tested phenotype B with blood samples of cats that tested phenotype A to confirm the blood phenotype B. The cross-tested among cats with phenotype A was made in order to verify the presence of different antigens of AB system in this blood phenotype. The results underwent macroscopic and microscopic analyses. Among the 300 animals tested, regarding breed, 290 were mixed-breed cats and among the remaining ten, five were Persians, four Siamese, and one Angora. 297 (99%) presented with phenotype A (including all the breeding cats) and three (1%) with phenotype B, and all this cats were mixed-breed cats. None (0%) of the cats showed the phenotype AB. All phenotype B bloods reacted to reverse phenotyping with phenotype A, confirming the phenotype B of these cats. All phenotype A bloods were compatible among each other, so no further erythrocyte antigens were detected through this test. The mother of one of the phenotype B cats was identified and had phenotype A, demonstrating phenotype A parents with phenotype B offspring. This finding indicates heterozygosis in the studied population. This data enable to conclude that the studied population presented different erythrocyte phenotypes, subsequently highlighting the importance of conducting phenotype analyses in these animals before performing blood transfusion to avoid serious hemolytic complications associated with incompatibility.(AU)

O objetivo deste estudo foi determinar a frequência dos fenótipos eritrocitários do sistema AB felino e verificar a presença de outros antígenos, não pertencentes ao sistema AB felino, em gatos domésticos das cidades de Ilhéus e Itabuna, Bahia, Brasil. Amostras de sangue de 300 gatos foram coletadas no Hospital Veterinário da Universidade Estadual de Santa Cruz (UESC) e em visitas domiciliares para realizar a fenotipagem sanguínea usando o método de tubo. A fenotipagem reversa foi realizada em gatos que testaram o fenótipo B com amostras que testaram o fenótipo A, para confirmação do fenótipo sanguíneo. O teste cruzado foi realizado entre gatos do fenótipo A, para pesquisar a presença de diferentes antígenos do sistema AB dentro desse fenótipo sanguíneo. Os resultados foram submetidos a análises macroscópicas e microscópicas. Dos 300 animais testados, 110 eram machos e 190 fêmeas, e suas idades variaram de cinco meses à 15 anos. Sobre as raças, 290 eram gatos sem raça definida e dos 10 restantes, cinco eram Persas, quatro eram Siameses e um Angorá. 297 (99%) apresentaram fenótipo A (incluindo todos os gatos de raça) e três (1%) tiveram fenótipo B, sendo todos esses gatos sem raça definida. Nenhum (0%) dos gatos apresentou fenótipo AB. Todos os sangues com fenótipo B reagiram na fenotipagem reversa com o fenótipo A, confirmando o fenótipo B desses gatos. Todos os sangues com fenótipo A foram compatíveis entre si, portanto nenhum antígeno eritrocitário adicional foi detectado através deste teste. A genitora de um dos gatos com fenótipo B, foi encontrada e a mesma possuía fenótipo A, demonstrando pais com fenótipo A e cria com fenótipo B. Esse achado indica heterozigose na população estudada. Esses dados levam à conclusão de que diferentes fenótipos eritrocitários estão presentes na população estudada e destacam a importância da realização de testes fenotípicos nesses animais antes dos procedimentos de transfusão, a fim de evitar complicações hemolíticas graves decorrentes do envolvimento de animais incompatíveis.(AU)

Animals , Cats , Phenotype , Blood Transfusion , Erythrocytes , Isoantibodies , Universities , Cats/blood
Med. lab ; 25(3): 605-617, 2021. tab, ilus
Article in Spanish | LILACS | ID: biblio-1343485


La hemofilia A es una enfermedad hereditaria ligada al cromosoma X, causada por mutaciones en el gen F8 del factor VIII de la coagulación. Se considera una enfermedad huérfana, ya que su prevalencia es baja, de 26,6 por cada 100.000 nacidos vivos de sexo masculino. Los pacientes con hemofilia A tienen fases de inicio y amplificación de la coagulación relativamente normales y son capaces de formar el tapón plaquetario inicial en el lugar de la hemorragia, pero debido a la deficiencia del factor VIII, son incapaces de generar una cantidad de trombina en la superficie de las plaquetas, que sea suficiente para estabilizar el coágulo de fibrina. En un paciente masculino con hemorragias inusuales debe descartarse un trastorno de coagulación tipo hemofilia A, y se debe solicitar un recuento de plaquetas y un tiempo de protrombina (TP), los cuales usualmente son normales, y un tiempo de tromboplastina parcial activado (TPT) que se presenta prolongado. Para el diagnóstico diferencial con otras coagulopatías se realiza la medición de factores de coagulación, y pruebas de corrección cuando existe la sospecha de un inhibidor o de una hemofilia adquirida. Los pacientes afectados pueden presentar formas leves, moderadas o severas de la enfermedad, según el nivel plasmático del factor. En Colombia y en el mundo, la hemofilia fue reconocida como una enfermedad huérfana que representa un problema de salud pública, debido a su proceso de atención altamente especializado, que incrementa los costos asociados con la asistencia sanitaria, y afecta la calidad de vida de los pacientes y de aquellos que los rodean, además de que representa un reto diagnóstico que requiere constante actualización, para que pueda ser tratada de manera efectiva

Hemophilia A is an X-linked inherited disease caused by mutations in the coagulation factor VIII F8 gene. It is considered a rare disease, as its prevalence is 26.6 per 100,000 live male births. Patients with hemophilia A have a relatively normal coagulation onset and amplification phases, and are able to form the initial platelet plug at the site of hemorrhage; but due to factor VIII deficiency, they are unable to generate a sufficient amount of thrombin on the platelet surface to stabilize the fibrin clot. In a male patient with unusual bleeding, a hemophilia A-type coagulation disorder should be ruled out, and blood tests such as a platelet count and prothrombin time (PT), which are usually normal, and an activated partial thromboplastin time (APTT), which is prolonged, should be requested immediately. For differential diagnosis with other coagulopathies, measurement of coagulation factors and correction tests are performed when there is suspicion of an inhibitor or acquired hemophilia. Affected patients may present mild, moderate or severe forms of the disease, depending on the plasma level of the factor. In Colombia and worldwide, hemophilia was recognized as a rare disease that represents a public health problem due to its highly specialized care, which increases the costs associated with health care, and affects the quality of life of patients and those around them, as well as representing a diagnostic challenge that requires constant updating, so that it can be treated effectively

Rare Diseases , Partial Thromboplastin Time , Hemophilia A , Isoantibodies
Arq. ciências saúde UNIPAR ; 24(3): 133-138, set-dez. 2020.
Article in Portuguese | LILACS | ID: biblio-1129455


Quando um indivíduo é exposto a antígenos eritrocitários não próprios, ocorre uma resposta imunológica, que leva à produção de anticorpos irregulares voltados contra esses antígenos. Esse processo é conhecido como aloimunização eritrocitária e acontece em decorrência de transfusões de sangue ou gestações incompatíveis. Na medicina transfusional a pesquisa de anticorpos irregulares é fundamental, pois a falha na detecção de um aloanticorpo pode provocar reações transfusionais, aloimunizações, anemias hemolíticas autoimunes e doença hemolítica perinatal. Este estudo tem por objetivo analisar a frequência de anticorpos irregulares de pacientes atendidos no Hemocentro Regional de Francisco Beltrão, Paraná, no ano de 2017. Os dados foram coletados a partir da revisão de registros em arquivos do Laboratório de Imunohematologia do Hemonúcleo. Foram avaliados dados de 49 protocolos de pacientes que apresentaram dificuldades transfusionais no ano de 2017. Dentre os pesquisados, 37 pacientes (75,5%) apresentaram anticorpos irregulares. Dentre os anticorpos anti-eritrocitários observados neste estudo, evidenciou-se a presença de doze pacientes com anti-D (27,2%), seis pacientes com anti-K (13,6%), quatro pacientes com anti-C (9,0%) e em seis pacientes (13,6%) foi observada a presença de autoanticorpos. Este estudo indica que, nos pacientes transfundidos, os anticorpos mais frequentes foram os aloanticorpos Anti-D do Sistema Rh, provavelmente devido ao seu alto grau de imunogenicidade. A prevalência desses anticorpos é semelhante a vários estudos encontrados na literatura.

When an individual is exposed to not-self red blood cell antigens, an immune response occurs, which leads to the production of irregular antibodies directed against these antigens. This process is known as erythrocyte alloimmunization and occurs as a result of blood transfusions or incompatible pregnancies. In transfusion medicine, the search for irregular antibodies is essential, since failure to detect an alloantibody can cause transfusion reactions, alloimmunizations, autoimmune hemolytic anemias, and perinatal hemolytic disease. This study aims at analyzing the frequency of irregular antibodies of patients seen at the Regional Blood Center of Francisco Beltrão, Paraná, in 2017. The data were collected from the review of records in files of the Immunohematology Laboratory of Hemonúcleo. Data from 49 protocols of patients who had transfusion difficulties in 2017 were evaluated. Among those surveyed, 37 patients (75.5%) had irregular antibodies. Among the anti-erythrocyte antibodies observed in this study, the presence of twelve patients with anti-D (27.2%), six patients with anti-K (13.6%), four patients with anti-C (9.0 %), and in six patients (13.6%) with the presence of autoantibodies were observed. This study indicates that, in transfused patients, the most frequent antibodies were the Rh System Anti-D alloantibodies, probably due to their high degree of immunogenicity. The prevalence of these antibodies is similar to several studies found in the literature.

Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Autoantibodies/immunology , Isoantibodies/immunology , Autoantibodies/isolation & purification , Blood Transfusion , Retrospective Studies , Sex Distribution , Age Distribution , Erythrocytes/immunology , Transfusion Reaction/immunology , Isoantibodies/isolation & purification , Antibodies/isolation & purification , Antibodies/immunology
Rev. chil. pediatr ; 91(2): 232-238, abr. 2020. tab
Article in Spanish | LILACS | ID: biblio-1098896


Resumen: Introducción: El desarrollo de aloanticuerpos neutralizantes anti-factor VIII en hemofilia A es la complicación más seria relacionada al tratamiento. La inducción de tolerancia inmune (ITI) o inmunotolerancia es el único tratamiento que erradica inhibidores, permitiendo utilizar nuevamente factor VIII para el tratamiento o profilaxis de eventos hemorrágicos. Objetivo: reportar la experiencia en niños sometidos a inmunotolerancia en la red pública del país. Pacientes y Método: Análisis retrospectivo y descriptivo de 13 niños con Hemofilia A severa e inhibidores persistentes de alto título, que recibieron ITI y seguimiento completo. Se utilizó concentrado de FVIII plasmático en dosis de 70-180 UI/Kg/diarias, definiendo éxito como la negativización del inhibidor y recu peración de la vida media del FVIII. Resultados expresados en media (rango). Resultados: En 13 pacientes se identificó el inhibidor, a una edad de 17,6 meses (2-48), tras 35,2 días (9-112) de exposición a FVIII. Once pacientes (84,6%) recuperaron la vida media del FVIII, tras 49,6 meses (26-70) de tratamiento. En los pacientes que respondieron, el título del inhibidor se negativizó en 7,3 meses (1-20). Conclusiones: En niños con hemofilia A e inhibidores persistentes de alto título, la ITI tiene un elevado éxito. Dado que el tiempo de respuesta es variable, la inmunotolerancia debe ser personalizada.

Abstract: Introduction: The development of anti-factor VIII neutralizing antibodies in hemophilia A is the most severe com plication related to treatment. Immune tolerance induction (ITI) is the only known treatment for eradicating inhibitors. A successful ITI allows using factor VIII (FVIII) again for the treatment or prophylaxis of hemorrhagic events. Objective: To report the experience of pediatric patients who underwent ITI in the country's public health care network. Patients and Method: Retrospective and descriptive analysis of 13 pediatric patients with severe Hemophilia A and high-titer inhibitors persis tence who underwent ITI and complete follow-up. Plasma-derived FVIII concentrate was used at 70 180 IU/kg/day doses. The success of the treatment is defined by achieving a negative titer and a half life recovery of the FVIII. The results were expressed in median (range). Results: In 13 patients, the inhibitor was identified at an average age of 17.6 months, after 35.2 days of exposure to the FVIII. 11 patients (84.6%) recovered the half-life of FVIII after 49.6 months of treatment. In the patients who responded to treatment, the inhibitor titer was negative at 6 months on average. Conclusions: ITI is the treatment of choice for patients with hemophilia A and inhibitors persistence. ITI must be perso nalized since the time response is variable in each patient.

Humans , Male , Female , Infant , Child, Preschool , Child , Factor VIII/therapeutic use , Hemophilia A/therapy , Immune Tolerance/immunology , Immunotherapy/methods , Isoantibodies/immunology , Factor VIII/immunology , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Hemophilia A/immunology
Article in Chinese | WPRIM | ID: wpr-827178


OBJECTIVE@#To retrospectively analyze the identification results of irregular antibodies, to clarify the distribution features and to explore the relation of alloantibodies and autoantibodies with the immunized history of patients and disease kinds.@*METHODS@#49 820 patients who applied for red blood transfusion during Sep 1st 2017 to Sep 1st 2018 were selected. All the specimens were screened for the antibody by microcolumn gel antiglobulin technique, which then were identified for irregular antibody.@*RESULTS@#Antibodies were found in 861 (1.73%) of all 49 820 transfused samples. The alloimmunization history of the patients with antibodies was significantly different between male and female (χ=18.54,P<0.01). The alloantibody was the most common, accounting for 59.50% in all of the antibodies. Warm autoantibody, anti-E, anti-M, anti-cE and anti-Ce accounted for 68.5% of the antibodies. The blood group of Rh, MNS and Lewis were responsible for 92.40% of alloantibody, especially anti-E accounted for the largest percentage(38.60%) of alloantibody. Patients with alloantiboies experienced much more the alloimmunization and transfusion history (χ=20.13,P<0.01;χ=5.40,P<0.05) . The distribution of auto and alloantibody was very significantly different among the ddifferent isease (χ=51.8,P<0.01), Hematopathy, solid tumor and osteoarthropathy were often associated with alloantibody, otherwise, autoantibodies often occurred in hematopathy and autoimmune disease.@*CONCLUSION@#The most important factor that results in antibody-screening positive is alloantibody, in which anti-E antibody from Rh blood group system in most common.

Antibodies , Allergy and Immunology , Blood Group Antigens , Blood Transfusion , Erythrocytes , Female , Humans , Isoantibodies , Male , Retrospective Studies
Einstein (Säo Paulo) ; 18: eRC4582, 2020.
Article in English | LILACS | ID: biblio-1039732


ABSTRACT The correct identification of erythrocyte antibodies is fundamental for the searching for compatible blood and haemolytic transfusion reactions prevention. Antibodies against antigens of high prevalence are difficult to identify because of the rarity of their occurrence and unavailability of negative red cells for confirmation. We report a case of 46-years-old woman, diagnosed with hemoglobinopathy, and who had symptomatic fall in hemoglobin levels (5.3g/dL) after blood transfusion suggestive of transfusion reaction. The patient's blood type was O RhD-positive. Irregular antibody screening was positive and demonstrated a panreaction against all erythrocytes tested, but this result was not reactive with dithiothreitol. Using negative red cells for antigens of high prevalence of our inventory we could identify in the serum of the same erythrocytes an anti-Holley antibody associated with anti-E. Molecular analysis confirmed that the patient was negative for E and Holley antigens. The crossmath with compatible units confirmed the results. Holley is a high prevalence antigen of the Dombrock blood system whose negative phenotype is extremely rare in all populations and is associated with hemolytic transfusion reactions. This is an antibody that is difficult to identify because laboratories need to have experience in solving complex cases, and have available a large stock of rare sera and erythrocytes, as well other tools such as enzymes, thiol reagents and molecular tests. The correct identification of a rare antibody is initial and mandatory for searching of compatible donors, and to guarantee a satisfactory transfusional support.

RESUMO A correta identificação dos anticorpos eritrocitários é fundamental na busca de sangue compatível e na prevenção das reações transfusionais hemolíticas. Anticorpos contra antígenos de alta prevalência são de difícil identificação, devido à raridade de sua ocorrência e à indisponibilidade de hemácias negativas para sua confirmação. Apresentamos aqui o caso de uma paciente do sexo feminino, 46 anos, com diagnóstico de hemoglobinopatia, que apresentou queda sintomática dos níveis de hemoglobina (5,3g/dL) após transfusão sanguínea, sugestiva de reação transfusional. O tipo sanguíneo da paciente era O RhD-positivo. A pesquisa de anticorpos irregulares foi positiva, demonstrando panreação contra todos os eritrócitos testados, mas não reativo ao ditiotreitol. Utilizando hemácias selecionadas negativas para antígenos de alta prevalência do nosso inventário, foi possível identificar no soro da mesma um anticorpo anti-Holley associado a um anti-E. A análise molecular confirmou que a paciente era negativa para os antígenos E e Holley, e as provas de compatibilidade com unidades fenotipadas confirmaram os resultados. Holley é um antígeno de alta prevalência do sistema sanguíneo Dombrock, cujo fenótipo negativo é extremamente raro em todas as populações e está associado a reações transfusionais hemolíticas. Trata-se de anticorpo de difícil identificação, pois os laboratórios precisam ter experiência na resolução de casos complexos, grande estoque de soros e eritrócitos raros, além de outras ferramentas, como enzimas, reagentes tiol e testes moleculares. A identificação correta de um anticorpo raro é inicial e obrigatória para a busca de doadores compatíveis, garantindo um suporte transfusional satisfatório.

Humans , Female , Blood Group Incompatibility/immunology , Blood Group Antigens/immunology , Transfusion Reaction/immunology , Antibodies/immunology , Immunoglobulins/blood , Erythrocytes/immunology , Hematologic Tests/methods , Isoantibodies/immunology , Middle Aged , Antibodies/blood
Rev. cuba. hematol. inmunol. hemoter ; 35(2): e929, abr.-jun. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093268


Introducción: Los anticuerpos irregulares corresponden a aquellos distintos a los anticuerpos naturales anti-A o anti-B, los cuales pueden aparecer en respuesta a la exposición a un antígeno eritrocitario extraño (transfusión o trasplante) o por incompatibilidad materno-fetal. Objetivo: Caracterizar a los donantes con rastreo de anticuerpos irregulares positivo de un banco de sangre de Montería, Colombia, durante el periodo 2012-2015. Métodos: Estudio transversal y retrospectivo, con fuente de información secundaria, basada en los resultados del rastreo de anticuerpos en los donantes de un banco de sangre de Montería, Colombia, entre los años 2012 y 2015. La población estuvo conformada por todos los donantes voluntarios registrados en el tiempo del estudio (35 248 donantes), a quienes se les realizó rastreo de anticuerpos. Como muestra, se seleccionaron todos los casos que tuvieron resultados positivos (71 donantes). Los datos fueron organizados en tablas y analizados en el software SPSS 21.0, Microsoft Excel y en Epidat versión 3.1. Resultados: El 0,2 por ciento de la población presentó un rastreo de anticuerpos positivo con un intervalo de confianza entre 0,15 y 0,25 por ciento. Los anticuerpos irregulares fueron más frecuentes en los hombres y en donantes O Rh positivo. Se encontraron Ac irregulares con 13 especificidades diferentes, con predomino de anti-M, anti-Lea, anti-D y anti-E y porcentajes respectivos de 27,78 por ciento, 20,83 por ciento, 9,72 por ciento y 8,33 por ciento. El 50 por ciento de los donantes tenía 30,5 años o menos, el 49,3 por ciento había donado previamente y el 9,9 por ciento recibió al menos una transfusión en algún momento de su vida. Conclusión: La frecuencia de donantes con rastreo de anticuerpos irregulares positivo fue baja, el sexo masculino presentó mayor porcentaje, se detectó principalmente en el grupo sanguíneo O y dentro de los anticuerpos irregulares, anti-M presentó una mayor frecuencia(AU)

Introduction: Irregular antibodies correspond to those other than natural anti-A or anti-B antibodies, which may appear in response to exposure to a foreign erythrocyte antigen (transfusion or transplantation) or due to maternal-fetal incompatibility. Objective: To characterize the donors with positive irregular antibody screening of a blood bank in Monteria, Colombia during the period 2012-2015. Methods: Cross-sectional and retrospective study, with secondary information source, based on the results of the antibody screening in donors of a blood bank in Monteria, Colombia from 2012 to 2015. The population consisted of all voluntary donors registered in the study time (35 248 donors), who were screened for antibodies. As a sample, all cases that had positive results (71 donors) were selected. The data was organized in tables and analyzed in the software SPSS 21.0, Microsoft Excel and in Epidat version 3.1. Results: 0.2 percent of the population presented a positive antibody screen with a confidence interval between 0.15 and 0.25 percent Irregular antibodies were more frequent in men and in O Rh positive donors. Thirteen types of irregular antibodies were found, with predominance of anti-M, anti-Lea, anti-D and anti-E and respective percentages of 27.78 percent, 20.83 percent, 9.72 percent and 8.33 percent. 50 percent of the donors were 30.5 years old or less, 49.3 percent had previously donated and 9.9 percent received at least one transfusion at some point in their lives. Conclusion: The frequency of donors with irregular positive antibody screening was low, the male sex had a higher percentage, it was detected mainly in blood group O and within the irregular antibodies, anti-M showed a higher frequency(AU)

Humans , Male , Female , Blood Donors/statistics & numerical data , Isoantibodies/therapeutic use , Cross-Sectional Studies , Retrospective Studies , Colombia , Antibodies
Article in Chinese | WPRIM | ID: wpr-771920


OBJECTIVE@#To investigate the feasibilily of screening and identifying the red blood cell type alloantibodies by means of surface plasman resonance(SPR) technique so as to provide a new method for detecting the transfusion compatibility of red blood cells.@*METHODS@#The RBC antigens for screening the alloantibody were fixed on the SPR chip surface by means of amino coupling method; the analysis conditions of SPR chip were optimized and then the control serum with RBC blood group antibody positive was detected; the performance of SPR chip for detection of serum was analysed; the consistance of rusults detected by SPR technique and microcolum agglutination for clinieal samples of 129 thalasstmia patients with history of lone-term blood transfusion were compared; at the same time, the blood group amtibodies in 7 patients with blood group antibody positive were identified before blood transfusion by using SPR chip so as to select the RBC antigen compatible blood for transfusion; and the efficacy of RBC transfusion was followed up and evaluated.@*RESULTS@#The repeatability, sensitivity and specificity of SPR chip technique for detecting the blood group alloantibodies all were better. The SPR technique and microcolumn agglutination method were not significant different for screening blood group alloantibodies (χ2 = 0.333, P>0.05), and the overall consistency was 97.2%; the results of SPR technique in 7 patients with positive blood group antibodies were as follows: 3 cases with anti-E, 1 case anti-M, 1 case anti-C, 1 case anti-Jka and 1 case autoantibody, which were consistent with the results of microcolumn agglutination tests, and the compatible red blood cells were selected for transfusion, of which the infusion of 6 cases was effective. In only 1 case the infusion was ineffective because of autoantibody.@*CONCLUSION@#For screening and identification of blood group alloantibodies, the performance of SPR chip technique is equivalent to the micro-column agglutination, but the procedure of SPR technique is simpler, faster and high-throughput and label-free, which can meet the basic requirements for rapid screening and identification of blood group alloantibodies before transfusion of red blood cells.

Blood Group Antigens , Blood Transfusion , Erythrocytes , Humans , Isoantibodies , Surface Plasmon Resonance
Article in Chinese | WPRIM | ID: wpr-771859


OBJECTIVE@#To explore the feasibility of RhCcEe blood group antigen mixed visual field identification in patients with regular blood transfusion, to follow up and evaluate the efficacy of matched transfusion and its clinical significance.@*METHODS@#RhCcEe genotyping for 142 patients with regular transfusion in our hospital was carried out by PCR-SSP method. According to the results of genotyping, 48 patients voluntarily selected the continuous transfusion of RhCcEe matched red blood cells, 46 patients received random blood transfusion (RhCcEe mismatched transfusion), 42 patients received partial RhCcEe matched transfusion (unable to provide fully matched RhCcEe donors each time), and 6 patients' blood transfusion data were lost. After 3-6 months of the RhCcEe matched transfusion, all patients were tested by RhCcEe microcolumn gel card and compared with the results before RhCcEe matched transfusion. The positive rates of alloantibodies, DAT and the percentage of red blood cell invalid transfusion were followed up and evaluated for the above-mentsioned 3 types of regular transfusion patients in the past 5 years.@*RESULTS@#Out of the 48 patients who underwent conti-nuous RhCcEe matched transfusion, only 1 case showed stratification, the remaining 47 cases had clear gel card results without stratification, suggesting that PCR-SSP genotyping was feasible. In addition, another 42 patients who could not receive RhCcEe matched transfusion each time and 46 patients with random blood transfusion were found to have a mixed vision phenomenon again. but the results was still difficult to confirm the results. For the transfusion results in the past 5 years, follow-up analysis showed that there were 1 case alloantibody (anti-Jka) (1/48) , 1 case of DAT positive (1/48) and 2 cases of invalid transfusion (2/48) in the RhCcEe matched transfusion group; 7 cases of alloantibodies (3 anti-E, 1 anti-E+anti-c, 1 anti-C, 1 anti-M, 1 anti-Fya) (7/46), 6 case of DAT positive (6/46) and 9 case of invalid transfusion (9/46) in the random transfusion group; 6 cases of alloantibodies (1 anti-E, 1 anti-E+autoantibody, 1 anti-C, 1 anti-c, 1 anti-M and 1 other antibody) (6/42) and 7 case of DAT positive (7/42) and 8 case of invalid transfusion (8/42) in the partial RhCcEe matched transfusion group. The statistical analysis showed that the positive rate of alloantibodies and the invalid infusion rate of RBC in each group were significant differences between RhCcEe matched transfusion group and the random transfusion group as well as betwen Rhce fe matched transfusion group and the partial matched transfusion group(P<0.05), but there was no statistical difference between the random transfusion group and the partial matched transfusion group(P>0.05).@*CONCLUSION@#PCR-SSP genotyping technique can be used to detect RhCcEe mixed vision in patients with regular blood transfusion. Continuous RhCcEe matched transfusion can effectively prevent the occurrence of alloimmunization, and improve the clinical transfusion efficacy and safety of the patients with regular blood transfusion, which has very important clinical significance.

Blood Group Antigens , Blood Transfusion , Humans , Isoantibodies , Transfusion Reaction , Visual Fields
Article in Korean | WPRIM | ID: wpr-759595


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.

Antibodies , Antibody Specificity , Blood Donors , Erythrocytes , Hemodilution , Humans , Isoantibodies , Korea , Mass Screening , Operative Blood Salvage , Sensitivity and Specificity , Transfusion Reaction
Article in English | WPRIM | ID: wpr-759583


BACKGROUND: In pregnant women, the frequency of irregular antibodies that cause hemolytic disease of the fetus and newborn (HDFN) vary between study populations. The clinical manifestations of HDFN differ according to the specificities and degree of irregular antibodies. This study examined the frequency and nature of maternal alloimmunization and neonatal outcomes. METHODS: Pregnant women, who underwent irregular antibody screening for prenatal testing at an obstetrics clinic in a single center, were enrolled. Those who screened positive for irregular antibodies were selected as the test group, and age- and obstetrics history-matched pregnant women were selected as the control group to evaluate the pregnancy outcomes according to irregular antibodies. RESULTS: The prevalence of irregular antibodies was 2.78% (42/1,508). With the exception of an unidentified antibody, anti-D was the most frequently identified antibody, followed in order by anti-E and anti-Le(a). The rate of fetal death was higher in the test group (6/37, 16.2%) than in the control group (1/37, 2.7%) (P=0.047). Eight pregnant women had anti-C or anti-D, one woman had a stillbirth, and four living neonates developed hyperbilirubinemia. Of six pregnant women with anti-E alone or with other alloantibodies, three experienced a spontaneous abortion or stillbirth. Among the six newborns with maternal anti-Le(a) and anti-Jk(a), four developed hyperbilirubinemia, but their mothers did not experience a spontaneous abortion or stillbirth. CONCLUSION: The prevalence of unexpected antibodies among pregnant Korean women was 2.78%. A significant difference in neonatal outcomes was observed, including the death rate, prematurity, and hyperbilirubinemia, depending on the specificity of the unexpected antibody.

Abortion, Spontaneous , Antibodies , Female , Fetal Death , Fetus , Humans , Hyperbilirubinemia , Infant, Newborn , Isoantibodies , Mass Screening , Mortality , Mothers , Obstetrics , Pregnancy , Pregnancy Outcome , Pregnant Women , Prevalence , Sensitivity and Specificity , Stillbirth
Article in Korean | WPRIM | ID: wpr-759582


BACKGROUND: In platelets transfusion, alloimmunization against the HLA and HPA antigen present in the white blood cells/platelets of the donor blood occurred. In addition, unexpected red blood cell alloantibodies might be produced by the alloimmunization of red blood cells antigens in the transfused platelet component. Therefore, this study examined the incidence of red blood cell alloantibodies after platelet transfusion. METHODS: From January to December 2018, adult patients who requested platelet concentrates or single donor platelets were enrolled. The results of pre/post-transfusion test, including antibody screening test and antibody identification test, were collected the incidence of red blood cell alloantibody formation was then analyzed, retrospectively. RESULTS: A total of 685 patients received 11,894 units of platelet concentrates and 1,402 units of single donor platelets. The median patient age was 64 years and the number of blood transfusions was 4.1. The amount of transfusion per session was 7.3 units, and the total transfused platelet concentrates was 30.9 units. New red blood cell alloantibodies were detected in 0.9% of all patients, and the identification results were observed as unidentified non-specific antibody in 66.7% and anti-E antibodies in 33.3%. The incidence of alloantibody was proportional to the frequency and amount of platelet transfusion. CONCLUSION: This paper reported the incidence of red blood cell alloantibody after platelet transfusion for the first time in Korea. Although matched platelet concentrates supply may be not practical in terms of cost-effectiveness, it may be useful to recognize the possibility of red blood cell alloimmunization and expand the understanding of extended matching transfusion.

Adult , Antibodies , Blood Platelets , Blood Transfusion , Erythrocytes , Humans , Incidence , Isoantibodies , Korea , Mass Screening , Platelet Transfusion , Retrospective Studies , Tissue Donors
Blood Research ; : 204-209, 2019.
Article in English | WPRIM | ID: wpr-763076


BACKGROUND: Risk factors for the development of inhibitors in previously untreated patients (PUPs) have been reported; this is not the case in previously treated patients (PTPs) owing to fewer studies. Risk factors may differ for the development of PTP versus PUP inhibitors. We aimed to identify risk factors for PTP inhibitor development. METHODS: Participants were patients at a hemophilia treatment center in Korea with current or past history of factor VIII or factor IX alloantibodies. Observed inhibitors were classified as PUP or PTP inhibitors based on the cumulative number of exposure days. We compared the type and severity of hemophilia, mutation type, and family history of inhibitor between PUPs and PTPs. Events within 3 months before the first inhibitor detection, such as change of the factor concentrate used, short-term high exposure or continuous infusion of factor concentrate, history of surgery, infection, diagnosis of cancer, use of immunosuppressive or immunomodulator agents, and vaccination were compared between PUPs and PTPs. RESULTS: We observed 5 PUP inhibitors and 5 PTP inhibitors in 115 patients with hemophilia A. Events that might be related to the development of inhibitors within 3 months prior to the first inhibitor detection were observed in all 5 PTPs. On the contrary, no such events were observed in any PUPs. The observed events included a change in the factor concentrate used, subsequent chemotherapy, and short-term high exposure to factor concentrates for controlling hemorrhage and surgeries. CONCLUSION: Our results suggest a greater role of nongenetic factors in PTP inhibitor development.

Diagnosis , Drug Therapy , Factor IX , Factor VIII , Hemophilia A , Hemorrhage , Humans , Isoantibodies , Korea , Prevalence , Risk Factors , Vaccination