Crossmatch incompatibility caused by anti-I antibody: 38 cases, containing 1 rare case of adult i blood group producing anti-I / 中国输血杂志

ABSTRACT

【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.