Hemolytic disease of newborn caused by unexpected antibodies: a retrospective study of 287 cases / 中国输血杂志

【Objective】 To observe the distribution of non-ABO-HDN and its clinical relevance, so as to provide reference for clinical diagnosis and treatment. 【Methods】 A total of 287 cases of non-ABO-HDN recorded during January 2012 to August 2022 were enrolled and tested in our laboratory. The correlation between maternal history of blood transfusion, pregnancy, unexpected antibody titers, gender, ABO-HDN and transfusion therapy was analyzed by chi-square test. 【Results】 All 287 cases of non-ABO-HDN involved 13 kinds of unexpected antibodies of 6 blood group systems. Rh-HDN accounted for 96.17% (276/287), and anti-D-HDN accounted for 47.04% (135/287). The proportion of non-ABO-HDN patients without ABO-HDN requiring exchange/transfusion was significantly higher than that of non-ABO-HDN patients with ABO-HDN(P8) was significantly higher than that in the low titer group (≤8) (P<0.05). There was no significant difference in gender, mother′s history of blood transfusion, pregnancy and whether or not to exchange/transfusion (severity of illness). 【Conclusion】 Understanding the characteristics of non-ABO-HDN and the specific distribution of unexpected antibodies, the correlation between various factors and diseases and their clinical significance are conductive to timely taking necessary intervention measures and reducing the risk of complications.

Establishment of Shaanxi rare blood group information supply platform / 中国输血杂志

【Objective】 To establish a rare blood group information supply platform in Shaanxi Province. 【Methods】 The rare blood group information supply platform consists of sample registration, result registration, donor files and inventory blood. The blood donation codes of voluntary blood donors were recorded for blood typing, and the antigen identification results of each blood group system were registered, all stored in the rare blood type information supply platform. When receiving an application for unusual or rare blood type missing multiple conventional antigens or a certain high-frequency antigen, the corresponding antigen negative blood donors and their blood status (in stock or not) were queried from the donor profile module of the platform, and the inventory of blood of rare blood type was monitored dynamically. 【Results】 The results showed that 5.060% (273/5 398) of rare Rh phenotype donors, 1.540‰ (51/33 010) of donors lacking multiple regular antigens, and 13 O-type donors lacking high-frequency antigens were recorded in the rare blood type information supply platform. Among them, 0.019‰ (3/158 484) of Jk(a-b-) phenotype, 0.436‰ (2/4 586) of Di(a+b-) phenotype, and 4.030‰ (8/1 983) of Fy (a-b+) phenotype were stored in the blood bank for rare blood type. 【Conclusion】 The establishment of rare blood group information supply platform can meet the urgent demand for blood of rare blood types in clinical practice and ensure the safety of blood transfusion.

Application and evaluation of human antibodies in ABO grouping / 中国输血杂志

【Objective】 To evaluate the application of monoclonal typing reagents and human anti-A/B antibodies for absorption-elution test in ABO grouping. 【Methods】 The specificity of monoclonal typing reagents and human anti-A/B antibodies with standard A, B, O and AB phenotypes at 4 ℃, room temperature, and 37 ℃ were compared. Affinity was evaluated by the titer, agglutination time and agglutination intensity of the reaction with A1/B cells. 29 samples with ABO discrepancy were tested to evaluate the ability of monoclonal typing reagents and human anti-A/B antibodies to detect weak antigens in absorption-elution test. 【Results】 The specificity and affinity of human anti-A/B antibodies are low, and monoclonal typing reagents have cross reactivity. Human anti-A/B antibodies can detect most weak antigens in absorption-elution test with no cross reactivity. 【Conclusion】 In ABO grouping, the human anti A/B antibody binding absorption-elution test can serve as a supplement method for identifying ABO weak antigens. Accurate results can be obtained with reasonable reagents and corresponding methodology in serological tests,thus ensuring the safety of blood transfusion.

Distribution characteristics of unexpected antibody in 1 779 patients and corresponding blood transfusion strategy / 中国输血杂志

【Objective】 To observe the distribution of the unexpected antibodies in order to study the safety and strategies in 1 779 cases of clinical blood transfusion. 【Methods】 A total of 1 779 patients with unexpected antibodies were enrolled from transfusion candidates in various hospitals in Xi′an during a 10-year period(from 2012 to 2022.5). 【Results】 The unexpected antibodies were detected in 926(52.05%) of 1779 samples. The detected antibodies were mainly from 8 blood group systems and their distributions were as follows: Rh antibodies in 69.76%(646/926), Kidd in 2.59%(24/926), Lewis in 4.21%(39/926), MNS in 12.53%(116/926), P in 0.43%(4/926), Diego in 0.65%(6/926), Duffy in 0.54%(5/926), I in 0.97%(9/926), Rh+ MNS in 1.30%(12/926), Rh+ Lewis in 0.65%(6/926), Rh+ Kidd in 3.24%(30/926), Rh+ Diego in 1.51%(14/926), Rh+ Duffy in 0.86%(8/926), MNS+ Diego in 0.11%(1/926), Rh+ MNS+ Kidd in 0.22%(2/926), Rh+ Lewis+ Kidd in 0.22%(2/926), Rh+ Kidd+ P in 0.11%(1/926), Rh+ Kidd+ Diego in 0.11%(1/926). 【Conclusion】 According to the distribution of unexpected antibodies in Xi′an, antibodies from Rh system, were the most common ones.First, the production of unexpected antibodies can be effectively reduced by establishing Rh compatible blood transfusion. Secondly, antibody screen cells containing low-frequency antigens, such as Mur, Dia and Wra, should be reasonably selected to prevent missing detection of anti-low frequency antigen antibodies in Xi′an. Furthermore, the genotyping technology of rare blood group should be promoted and a rare blood group red blood cell bank be established to optimize the blood inventory and ensure the safety of blood transfusion.

Establishment and clinical application of Kidd, Diego, Duffy blood group system, Shaanxi Province / 中国输血杂志

【Objective】 To screen individuals with rare blood type of Kidd, Diego, Duffy blood group system among the voluntary blood donor in Shaanxi province and to establish on-line and physical database of rare blood type. 【Methods】 Jk(a-b-)phenotype donors were screened by 2 mol/L urea hemolysis test. Blood donors with Di(a+ b-) phenotype were screened by genotyping; Fy(a-) and D-- phenotype donors were screened by modified antiglobulin assay. 【Results】 Three cases of Jk(a-b-) phenotype were detected out of 158 484 voluntary blood donors. The distribution frequency of Jk(a-b-) phenotype was 0.019‰. Di(a+ b-) phenotype was detected in 2(0.436‰) cases out of 4 586 voluntary blood donor. Fy(a-) phenotype was detected in 8(4.034‰) cases out of 1 983 voluntary blood donors. D-- phenotype was not detected in 29 430 voluntary blood donors. 【Conclusion】 The on-line database of Kidd, Diego, Duffy blood group system had been established by large-size screening of blood donor samples, which can conclude the region′s population distribution and genetic characteristics of RBC blood group. And physical database could further be established using the technology of red blood cells cryopreservation when the conditionspermit, so as to provide the most compatible blood for the clinical effectively improve blood transfusion safety, and provide data support for blood early warning.

The processing of blood with irregular antibodies and its clinical application / 中国输血杂志

【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.

Effect of ABO blood group on coagulation factor Ⅷ activity and fibrinogen content in fresh plasma products / 中国输血杂志

【Objective】 Tostudy the effect of ABO blood group on the FⅧ∶C and Fib content in human plasma, so as to provide the oretical guidance for the quality control of fresh plasma products and the establishment of relevant quality standards. 【Methods】 Samples determined included fresh plasma collected and fresh plasma separated manually. The FⅧ∶C and Fib content were determined by coagulation method. The exon6 of ABO gene was amplified and sequenced to determine the genotype. 【Results】 The FⅧ∶C in fresh plasma collected was (147.421±45.773)%, and that in fresh plasma separated manually was (119.083±35.130)%, showing significant differences(P0.05). The FⅧ∶C in non-O type (A, B, AB type) fresh plasma collected and fresh plasma separated manually were (167.048±40.862)% and (129.251±33.503)%, respectively, significantly higher than that in O type fresh plasma collected and fresh plasma separated manually as(121.386±38.632)% and (91.589±22.328)%, respectively. The Fib contents in non-O type fresh plasma collected and fresh plasma separated manually were (2.242±0.385)g/L and (2.329±0.472)g/L, respectively. The Fib contents in O type fresh plasma collected and fresh plasma separated manually were (2.287±0.370)g/L and (2.307±0.462)g/L, respectively, and no significant difference was noticed (P>0.05). 【Conclusion】 There was no significant correlation between Fib content and ABO blood group, while FⅧ∶C was significantly correlated with ABO blood group. In the preparation and quality control of FⅧ related blood products, the effect of ABO blood group on the FⅧ∶C should be considered, and the quality standard of FⅧ in plasma products should be established based on the ABO blood group.

Study on molecular mechanism and pedigree investigationof para-bombay blood group caused by rare mutations at position h235 and position h649 of FUT1 gene / 中国输血杂志

【Objective】 To study the molecular mechanism of para-bombay blood group caused by two rare mutation combinations and investigate the pedigree. 【Methods】 ABO and H antigens were detected by serological test, and the ABO blood group was confirmed by gene detection; the FUT1 gene was amplified by PCR and sequenced. 【Results】 Serological results showed that the proband was a rare para-bombay blood Bhm, Le(a-b+ ), and the proband′s parents were both B Le (a-b + ). The sequencing results showed that the proband and his mother had mutation at h235 G→C of FUT1 gene. Proband and his father had mutation at h649 G→T of FUT1 gene. 【Conclusion】 The combination of two rare mutations resulted in the formation of a para-bombay phenotype, which is helpful to clarify the gene polymorphism and genetic heterogeneity of para-bombay phenotype, providing data support and theoretical basis for its blood group identification and safe and reasonable blood use of para-bombay phenotype.

Identification of a rare anti-Dib combined with multiple antibodies and clinical blood transfusion practice / 中国输血杂志

【Objective】 To identify one blood sample with ambiguous antibody screening result, explore the identification strategy of complex antibodies and provide blood transfusion plan. 【Methods】 Blood typing and antibody screening were performed by serological test. The genotyping of Diego blood group was carried out by gene detection. Absorption and elution test were designed to identify the complex antibodies. 【Results】 Serological test showed that the patient′s blood type was B, ccDEE, Jk(a-b+ ), Le(a-b+ ), Fy(a+ b-), Di(a+ b-). The results of genotyping showed that the Diego genotype of the patient was Di (a+ b-). Based on the above results, absorption and elution tests were designed and IgG anti-Dib, IgG anti-Ce, and IgG anti-Jka antibodies were detected in serum of the patient. Combined with the use of immunoglobulin and targeted blood transfusion measures, successful treatment was provided for the patient. 【Conclusion】 For the identification of antibodies against high frequency antigen combined with multiple antibodies, a variety of experimental techniques and methods should be combined, and the experimental scheme should be designed flexibly.

Antigen profile and antibody frequency of Wra in voluntary blood donors in Shaanxi province, containing 2 clinical cases of anti-Wra identification / 中国输血杂志

【Objective】 To understand the antigen profile and antibody frequency of Wra in voluntary blood donors in Shaanxi province. 【Methods】 Wra antigen and antibody screening as well as blood group typing and antibody identification were performed by serological tests and confirmed by genetic testing. 【Results】 The incidence of Wra antigen in 7 490 voluntary blood donors was 0.013%(1/7 490), and the frequency of anti-Wra in 729 voluntary blood donors was 0.823%(6/729). 【Conclusion】 This study explored the polymorphism of Wra antigen and antibodies in blood donors, which is informative in the risk assessment of blood transfusion and the screening and identification of respective antibodies.

Identification of a novel T421C mutation of α-1,3-N-acetylgalactosaminyltransferase allele responsible for an A variant / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the molecular basis of an individual featuring weak A phenotype of ABO blood group system.</p><p><b>METHODS</b>Serologic investigations, serum transferases activity assay and absorption-elution test were carried out to identify the ABO blood group. The 7 exons and flanking introns of ABO glycosyltransferase gene were amplified with polymerase chain reaction (PCR). The products were sequenced bidirectinally following enzyme digestion. Haplotypes of exons 6 and 7 of the ABO gene were analyzed.</p><p><b>RESULTS</b>A weak A antigen was identified on red blood cells of the proband. Eight heterozygous sites in exons 6 and 7 (261delG 297A/G, 421C/T, 467C/T, 646T/A, 681G/A, 771C/T, 829G/A) of the ABO gene were identified. Based on haplotype analysis, one allele was determined as O02, while a novel mutation 421T>C was identified in another allele, which resulted in the amino acid change Ser141Pro of the A glycosyltransferase.</p><p><b>CONCLUSION</b>Above results suggested that amino acid substitutions resulted from a novel mutation 421T>C of the ABO gene may decrease the enzymatic activity and result in the weak A phenotype.</p>