[Serological Characteristics and Clinical Significance of Irregular Antibodies in Pregnant Women].

OBJECTIVE: To understand the serological characteristics of irregular antibodies in pregnant women and explore their clinical significance. METHODS: From January 2017 to March 2022, 151 471 pregnant women in Women and Children's Hospital of Chongqing Medical University were enrolled in this study, microcolumn gel card test was used for irregular antibody screening, and antibody specificity identification was further performed in some antibody-positive subjects. RESULTS: The positive rate of irregular antibody screening in the enrolled pregnant women was 0.91% (1 375/151 471), 0.23% (355/151 471) was detected in the first trimester, 0.05% (71/151 471) in the second trimester, and 0.63% (949/151 471) in the third trimester. The positive rate of irregular antibody screening in the third trimester was significantly higher than that in the first and second trimester, and a significant increase in the number of positive cases was found in the third trimester than that in the second trimester. The analysis of agglutination intensity of 1 375 irregular antibody screening positive results showed that the weakly positive agglutination intensity accounted for 50.11% (689/ 1 375), which was the highest, the suspicious positive was 18.69% (257/1 375), and the positive was 31.20% (429/1 375). The significant difference in distribution of agglutination intensity was not observed between the first trimester group and the second trimester group, however, in the third trimester, the proportion of suspicious positive and weakly positive was lower than the first trimester, while, the proportion of positive was higher than the first trimester, and the difference was statistically significant (P < 0.001). Among the irregular antibody screening positive pregnant women, the proportion of pregnant women with pregnancy number ≥ 2 was significantly higher than that with pregnancy ≤ 1. Among 60 pregnant women who underwent antibody identification, the distributions of the antibodies were as follows: Rh blood group system accounted for 23.33% (14/60), Lewis system 43.33% (26/60), Kidd system 3.33% (2/60), MNS system 16.67% (10/60), P1PK system 1.67% (1/60), autoantibodies 1.67% (1/60), and 4 cases was unable to identify (6.67%, 4/60). Among specific antibodies, the anti-Lea was the most common (30.00%), followed by anti-E (16.67%) and anti-M (16.67%). CONCLUSION: The differences of irregular antibody serological characteristics exist in pregnant women from different regions with different genetic backgrounds, understanding the characteristics of irregular antibody in local pregnant women is of great significance for ensuring transfusion safety in pregnant women and preventing hemolytic disease of newborn.

[Correlation Analysis of Hemolytic Transfusion Reaction Induced by Low Titer Antibody].

OBJECTIVE: To establish the diagnostic process of low titer blood group antibody in the occurrence of adverse reactions of hemolytic transfusion. METHODS: Acid elusion test, enzyme method and PEG method were used for antibody identification. Combined with the patient's clinical symptoms and relevant inspection indexes, the irregular antibodies leading to hemolysis were detected. RESULTS: The patient's irregular antibody screening was positive, and it was determined that there was anti-Lea antibody in the serum. After the transfusion reaction, the low titer anti-E antibody was detected by enhanced test. The patient's Rh typing was Ccee, while the transfused red blood cells were ccEE. The new and old samples of the patient were matched with the transfused red blood cells by PEG method, and the major were incompatible. The evidence of hemolytic transfusion reaction was found. CONCLUSION: Antibodies with low titer in serum are not easy to be detected, which often lead to severe hemolytic transfusion reaction.

Correlation Analysis of Hemolytic Transfusion Reaction Induced by Low Titer Antibody / 中国实验血液学杂志

OBJECTIVE@#To establish the diagnostic process of low titer blood group antibody in the occurrence of adverse reactions of hemolytic transfusion.@*METHODS@#Acid elusion test, enzyme method and PEG method were used for antibody identification. Combined with the patient's clinical symptoms and relevant inspection indexes, the irregular antibodies leading to hemolysis were detected.@*RESULTS@#The patient's irregular antibody screening was positive, and it was determined that there was anti-Lea antibody in the serum. After the transfusion reaction, the low titer anti-E antibody was detected by enhanced test. The patient's Rh typing was Ccee, while the transfused red blood cells were ccEE. The new and old samples of the patient were matched with the transfused red blood cells by PEG method, and the major were incompatible. The evidence of hemolytic transfusion reaction was found.@*CONCLUSION@#Antibodies with low titer in serum are not easy to be detected, which often lead to severe hemolytic transfusion reaction.

Effect of clinical application of anti-CD38 and anti-CD47 monoclonal antibodies on blood group detection and transfusion therapy and treatment.

BACKGROUND: To investigate the effect of anti-CD38 monoclonal antibodies (mAb) (daratumumab, DARA) and anti-CD47 mAb combined with azacytidine on blood transfusion compatibility tests, transfusion effects in the treatment of multiple myeloma or acute myeloid leukemia and the corresponding management strategy. MATERIALS AND METHODS: Among the 19 patients who were treated with DARA and anti-CD47 mAb, 4 patients with cross matching incompatibility were selected. The ABO blood group, the Rh blood group, irregular antibody screening and direct antiglobulin test (DAT) and cross matching testing were performed before and after the application of mAbs using serological methods. Then, irregular antibody screening and microcolumn gel cross matching tests were performed with donor and recipient erythrocytes and serum treated with DL-dithiothreitol (DTT) and Immucor kit, respectively. The transfusion effect was monitored. RESULTS: 21.05% (4/19) patients had mismatched cross-matching results after mAb treatment. The agglutination intensity of irregular antibody screening tests (3 + ∼ 4 +) after anti-CD47 mAb was higher than that (1 + ∼ 2 +) after DARA. In the DARA group, treating RBCs with 0.2 mol L-1 DTT eliminated the DARA interference with antibody screening. In the anti-CD47 mAb group, the antibody screening, cross-matching test and DAT had been strongly interfered, and using Immucor kit eliminated the interference with antibody screening testing. There was no difference in the transfusion effect. CONCLUSION: The application of mAb drugs led to incompatibility of cross matching tests, and the transfusion effect was not affected.

Anti-Fya-mediated delayed hemolytic transfusion reaction following emergency-release red blood cell transfusion: possible involvement of HLA-DRB1*04:03 in the Japanese population.

A 43-year-old Japanese male, who had undergone open liver surgery for tumor resection, presented with decreased hemoglobin levels on Day 13 post-emergency-release transfusion of 16 units of Fy(a +) red blood cells. As the anemia was accompanied by increased lactate dehydrogenase, indirect bilirubin, and reticulocytes, as well as decreased haptoglobin, it was attributed to hemolysis. In the diagnostic workup for hemolytic reaction, the direct antiglobulin test result for IgG was positive and the antibody dissociated from the patient's peripheral red blood cells was identified as anti-Fya (titer, 4). The hemolytic reaction was transient (approximately 10 days), of moderate severity, and did not result in any obvious organ damage. However, a single compatible red blood cell transfusion of 2 units was required on Day 17 after the causative transfusion. Notably, HLA typing revealed that the patient carried the HLA-DRB1*04:03 allele, which has been implicated in immunogenicity and induction of anti-Fya response in Caucasian populations. In summary, this is the first documented case of definitive anti-Fya-mediated delayed hemolytic transfusion reaction associated with HLA-DRB1*04:03 in the Japanese population.

Blood group serological testings of ABO hemolytic disease of newborn: A retrospective analysis / 中国输血杂志

【Objective】 To retrospectively analyze blood samples of suspected hemolytic disease of newborn(HDN)mothers and infants, and detect hemolytic disease caused by irregular antibodies, so as to provide help for the clinical diagnosis and treatment of HDN. 【Methods】 632 suspected HDN samples from Obstetrics and Pediatrics Department of our hospital from January 2016 to October 2018 were collected, and serologically detected by microcolumn gel technique, as well as DAT, free antibody test and antibody release test. 【Results】 Among 632 samples, 306 were HDN positive, with a positive rate at 48.4%, 64 suspected HDN, accounting for 10.1%, and 262 non confirmed HDN, accounting for 41.5%. 180 samples were type A, among which 145 were HDN positive, with a positive rate at 80.56%; 233 were type B, among which 157 were HDN positive, wiht a positive rate at 67.38%; 210 were type O, among which 1 was HDN positive, with a positive rate at 0.48%; 9 were type AB, among which 3 were HDN positive, with a positive rate at 33.33%. The positive rates of HDN differed by blood types (P<0.05). In 632 suspected HDN samples, 9 were with irregular antibody + immune anti-A, and 136 with solo immune anti-A; 10 were with irregular antibody + immune anti-B, and 170 with solo immune anti-B; 1 was with irregular antibody + immune anti-A and anti-B, and 2 with immune anti-A and anti-B; 4 HDN cases were caused by irregular antibody, while anti-S and anti-E cconstituted 2 and 2 cases, respectively. 【Conclusion】 ABO HDN is more common and attracts more attention in clinical practice than HDN scaused by other group systems, which were rare and easy to be ignored, but also may cause moderate and severe HDN. even severe anemia, edema and stillbirth of fetus. Therefore, it is necessary to carry out irregular antibody screening during pregnancy so as to achieve early detection and treatment.

Electronic crossmatching based on Rh typing: reducing the production of Rh system alloantibody in blood transfusion recipients / 中国输血杂志

【Objective】 To study the application of electronic crossmatching(E-XM) based on Rh typing aimed at reducing the production of alloantibodies in blood recipients. 【Methods】 A total of 22 528 RhD positive patients, admitted to our hospital from Jan 1, 2018 to Mar 31, 2020, required the specific transfusion of leukocyte-depleted suspension red blood cells. Among which, 21 334 reached the priority level Ⅰ and Ⅱ by E-XM and were set as the control group, and 1 194 reached the priority level Ⅲ and were set as the experimental group. ABO and Rh (D, C, c, E and e antigens) blood group systems were serologically tested both in blood recipients and donors, and Rh phenotype database was established based on the blood transfusion management system. The incidence of irregular antibodies against the exposure of new antigens involved with RBC transfusions in the control group and the experimental group was compared. 【Results】 The proportion of antigen C and e was significantly higher than that of c and E. The frequency of DCCee and DCcEe were the highest, while that of Dccee and DCCEE were extremely low. 85.2% and 9.5% of the patients reached priority level Ⅰ and Ⅱ, respectively, and only 5.3% reached priority level Ⅲ. 6 patients(less than 0.001%) in the control group (n=21 334), developed Rh system alloantibodies after blood transfusion, and 24 patients(2.01%) in the experimental group (n=1194) developed Rh alloantibodies against the exposure of antigens after blood transfusion. There were significant differences between the experimental group and the control group (P<0.01). 【Conclusion】 The application of E-XM could minimize the incidence of Rh irregular antibodies after RBC transfusion in patients, which contributes to the safety in clinical blood transfusion.

The distribution characteristics of Rh phenotype and haplotype frequency in Qingdao: An analysis based on some patients and local blood donors / 中国输血杂志

【Objective】 To investigate the distribution characteristics of Rh blood group antigen phenotypes, haplotypes and irregular antibodies between patients in our hospital and local blood donors, so as to ensure safe and effective blood transfusion and improve the rationality and scientificity of clinical blood transfusion. 【Methods】 A total of 113 326 blood samples, from hospitalized patients in our hospital and local blood donors from October 2015 to March 2020, were subjected to Rh antigen typing and irregular antibody detection. The frequency of Rh phenotypes, haplotypes, and irregular antibodies were retrospectively analyzed and calculated. Chi square test was used to compare the data among different population groups. Rh antigen typing and irregular antibody detection were completed using the automatic blood group analyzer. 【Results】 The prevalence of negative RhD was 0.36% (408/113 326). The most prevalent Rh phenotype was DCCee [40.69%(46 112/ 113 326)] followed by DCcEe [36.82%(41 727/ 113 326)]. Anti-E was the most common irregular antibody, accounting for [0.26%(295/ 113 326)], and DCe [62.51%(70 840/ 113 326)] was the most common haplotype. The most common Rh phenotypes and haplotypes in Caucasians in Germany, North Indian and North African were DCcee, DCCee and Dccee, while DCe, DCe and Dce, respectively. 【Conclusion】 The distribution characteristics of Rh phenotypes, haplotypes and irregular antibodies of patients in our hospital and local blood donors were in line with the distribution characteristics of the population in northern China. Corresponding plans concerning blood storage and collection, as well as the establishment of Rh blood type registry should be carried to effectively ensure the safety, rationality and accuracy of clinical blood transfusion.

Correlation between irregular antibody profiles of non-Rh blood group system and incidence of hemolytic disease of the newborn, 53 cases / 中国输血杂志

【Objective】 To retrospectively analyze the irregular antibodies in 6 blood group systems other than the Rh blood group system in 53 pregnant women and analyze its correlation with the occurrence of hemolytic disease of the newborn(HDN). 【Methods】 19 473 pregnant women were screened for irregular antibodies by microgel detection technology combined with anti-human globulin (IgG+ C3d), and the positive samples screened out were further confirmed to understand the types and titers of irregular antibodies. Irregular antibody type determination experiment: IgG type irregular antibody titer was determined after mercaptoethanol (2-Me) inactivated the serum of the irregular antibody positive specimen, and then IgG and IgM type were determined by comparing the titer levels of irregular antibody. Three hemolysis tests and total bilirubin tests were performed on umbilical cord blood during delivery to analyze the level of jaundice and the occurrence of HDN. 【Results】 53 cases of irregular antibodies other than the Rh blood group system were detected in 19 473 pregnant women, with a positive rate of 0.27%, mainly MNS and Lewis blood group system.The incidence of HDN was 39.6% (21/53). There were 27 cases of IgM, 7 IgG, and 19 IgM + IgG. Comparison of total bilirubin detection between the low titer group (≤8) and the high titer group (>8) : the latter was significantly higher than the former (P<0.05); IgG antibody subtypes: IgG1 of the latter significantly increased (P<0.05), and so was IgG3 in former (P<0.05). There was a significant positive correlation between IgG1, IgG3 and total bilirubin. The area under the curve of IgG1+ IgG3 for HDN diagnosis, the sensitivity and specificity were 0.953, 0.900, and 0.967, respectively. 【Conclusion】 Other than Rh blood group system, irregular antibodies are mainly distributed in MNS and Lewis blood group system. The incidence of HDN is higher in Kell, Duffy and Kidd blood group systems after producing irregular antibodies. Non-antibody types are mostly IgM type or IgM + IgG mixed, and the incidence of HDN is not high; Patients with poor maternal history, either high or low titer, can be classified into IgG1 and IgG3 in early stages, and those with Abnormal results should be included into the perinatal management of high-risk women with regular checking.

Effect of blood component transfusion in patients with negative to positive results of direct antiglobulin test after blood transfusion / 中国输血杂志

【Objective】 To analyze the effect of blood component transfusion when the results of direct antiglobulin test (DAT) changed from negative to positive after blood transfusion. 【Methods】 The data of 215 surgical blood recipients, who were admitted in our hospital from January to October 2019 and presented negative results for both DAT and irregular antibody screening (Anti-screening), were collected via Ruimei Laboratory Management System. DAT and Anti-screening were performed again after blood transfusion, and DAT positive patients(re-test positive group) were then subject to antibody classification and polybrene cross-matching (referred to as cross-matching), and Anti-screening positive patients were tested for irregular antibodies. Patients were stratified by perioperative RBCs transfusion volume as ≤4 U (150 ± 10% mL/U), >4 to 8 U and > 8 U, and DAT-negative patients after blood transfusion were set as the controls, and the transfusion effect of DAT-positive patients after blood transfusion was compared with them. 【Results】 8.84% (19/215) of DAT-negative patients turned positive after RBCs transfusion, among which IgG type accounted for 84.21% (16/19) and IgG+ C3 15.79% ( 3/19); two patients(anti-E and-M, 10.53%) were positive in anti-screening re-test and the rest were negative (89.47%, 17/19). As for cross matching, incompatibility of both primary and secondary side, primary side and secondary side accounted for 5.26% (1/19), 5.26% (1/19) and 10.52 (2/19), respectively, while 78.95% (15/19) showed compatibility of both primary and secondary side. The Hb, RBC and Hct values of the re-test positive group, received RBC transfusion volume (U)≤4 and >4~8, were effectively elevated compared with the controls (P8 U(P>0.05). 【Conclusion】 The conversion of DAT negative results to positive after RBC transfusion indicates the patient has developed antibodies or the incidence of blood transfusion reaction, which can provide references for the clinical choice of appropriate blood components to ensure the safety and effectiveness of blood transfusion.

Correlation between Rh blood group antigen profiles in pregnant women and hemolytic disease of the newborn in Qingdao area: A retrospective study / 中国输血杂志

【Objective】 To investigate the profile of Rh blood group antigen in pregnant women and hemolytic disease of the newborn (HDN) in Qingdao area. 【Methods】 10 597 pregnant women admitted in our hospital during October 2016 to February 2020 were selected and the ABO, Rh blood group system antigen (D, C, c, E, e) and the irregular antibody were detected, and positive antibody was further identified. The irregular antibody of Rh blood group in pregnant women was statistically analyzed according to the history of blood transfusion and pregnancy. Twelve HDN cases were studied, and the results of ABO, Rh blood group antigen and irregular antibody, antibody property identification, HDN test and blood routine test were retrospectively analyzed. 【Results】 Among 10 513 cases of Rh-positive pregnant women, the common phenotype was CCee>CcEe>Ccee>ccEE>ccEe; among 84 cases of Rh-negative pregnant wome, the common phenotype was ccee>Ccee> CCee> ccEE>ccEe. The positive rate of irregular antibody was 1.06% (112/10597) in 10 597 pregnant women, of which the Rh antibody was the highest, rated at 56.25% (63/112). For 64 pregnant women with positive antibodies, antibodies against Rh system were different from those against other systems when stratified by the history of blood transfusion (P<0.05) and pregnancy (P<0.05). Twelve neonates were diagnosed with Rh-HDN, with IgG anti-E in 6 cases, IgG anti-D 3, IgG anti-cE 1, IgG anti-C 1and IgG anti-c 1. Among them, 3 were seriously ill and treated with blood exchange. 【Conclusion】 As two-child policy was implemented, the incidence of Rh HDN had increased. ABO, RhD, C, c, E and e matched transfusion should be administered for women at childbearing age. Meanwhile, clinical termination of delivery was recommended for pregnant women, who probably develop Rh-HDN and are with critical situation. Rh phenotype matched fresh blood should be prepared, which has great clinical significance for rescuing newborns.

Profile of irregular antibodies among voluntary blood donors: 2018 to 2020 in Jiaxing / 中国输血杂志

【Objective】 To study and analyze the profile of irregular antibodies among voluntary blood donors in Jiaxing area. 【Methods】 The ABO and RhD blood groups of all voluntary blood donors from November 2018 to November 2020 were detected by DIAGAST QWALYS 3 automatic blood group analyzer. According to routine serological screening program of irregular antibody, the samples reactive to O blood cell were sent to the reference laboratory for further identification of the antibody specificity, and the specificity and distribution characteristics of irregular antibodies were analyzed statistically. 【Results】 A total of 79 samples presenting irregular antibodies were yielded out of 90 854 blood samples, with a positive rate of 0.087%. More female samples (n=44) than male (n=35) (P0.05). 【Conclusion】 Female, RhD negative and more than 45 years old blood donors are more likely to present irregular antibodies, regardless of the number of blood donations.

Pre-transfusional screening and identification of irregular red blood cell antibody in different nationalities, Guizhou, China / 中国输血杂志

【Objective】 To analyze the frequency and profile of irregular antibodies in different ethnic groups through screening and identification of irregular antibodies in 67 552 blood recipients in the Affiliated Hospital of Guizhou Medical University. 【Methods】 Irregular antibody screening was carried out in patients with different ethnic groups from August 1, 2016 to July 31, 2019 by microcolumn gel anti human globulin method, and the irregular antibody specificity were identified by panel cells. 【Results】 1)307 out of 67 552 cases were positive for irregular antibody, with the positive rate at 0.45%(307/67 552). Among them, Chuanqing was 1.27%(6/473), Yi 1.15%(4/348), Buyi 1.03%(10/975), Dong 0.58%(3/514), Han 0.44%(273/62 365), Miao 0.42%(5/1 187) and Tujia 0.34%(2/596), with significant differences among nationalities. Irregular antibody detection: the positive rate of female patients(0.56%, 223/41 359) was higher than that of male patients(0.32%, 84/26 193)(P0.05). The yields of irregular antibodies did not differ by ABO blood groups(P>0.05). 3)The specificity of 307 irregular antibody positive cases involved 7 blood group systems, including Rh system 59.28%(182/307), MNSs system 9.12%(28/307), Kidd system 0.65%(2/307), Duffy system 0.98%(3/307), Lewis system 5.86%(18/307), P system 0.65%(2/307), and Digeo system 0.33%(1/307). In addition, 15.64%(48/307) of autoantibodies, 0.65%(2/307) of cold antibodies and 4.93%(15/307) of unclear antibodies were detected. 4)The distribution of anti-D, anti-C and autoantibodies were statistically significant among the Han, Buyi, Chuanqing, Miao, Yi and Dong nationalities(P0.05). 【Conclusion】 The distribution of irregular antibodies in Guizhou is different by nationalities. Routine screening of irregular antibodies for transfused or pregnant patients can increase the safety and efficacy of blood transfusion. Most of the irregular antibodies detected are Rh blood group system. The exposure to irregular antibodies can be reduced by additional detection of blood group antigen other than RhD for blood recipients and donors, as well as the blood transfusion with matched blood group antigens.

[Two serial events of delayed hemolytic transfusion reactions due to different primary immune response-induced irregular antibodies].

A 74-year-old woman with a history of pregnancies, but without previous transfusions, received a red blood cell transfusion for aplstic anemia. She lost consciousness due to severe anemia two weeks later and was transported by ambulance to our hospital. Delayed hemolytic transfusion reaction (DHTR) was diagnosed based on the detection of anti-E antibody and positive E antigen of the previously transfused product. A transfusion of E antigen-negative red cell products was performed. However, DHTR due to anti-c antibody developed 16 d after the transfusion of a c antigen-positive product. Based on the onset of ≥14 d after the transfusions and the detection of a causative IgM-type antibody, DHTR due to a primary immune response was diagnosed. Because the incidence of DHTR is low, physicians rarely experience it in clinical practice. However, in our case, DHTR due to a primary immune response, which is even rarer in DHTR cases, developed twice within a short period. A history of transfusion and pregnancy as well as preexisting irregular antibodies have been identified as risk factors for DHTR. Thus, more attention should be paid to the risk of DHTR redevelopment by repeated transfusions.

Anti-H antibody of unusually high titer showing variable reactivities against group A red cells and broad thermal amplitude in a patient with lymphoma.

We report a case of a patient with high titer anti-H antibody showing broad thermal amplitude and variable reactivities against group A red cells. A 62-year-old Korean female was diagnosed with diffuse large B cell lymphoma involving multiple organs. Her ABO/RhD type was A+ and her genotype was ABO*A.01.01/ABO*O.01.02. Antibody screening test (AST) and antibody identification test (IDT) were strongly positive for all reagent cells. Anti-human globulin (AHG) test revealed an antibody titer of 1:256 for 37 °C phase and trace positivity for poly- and mono-specific C3d. Reactivity was stronger for O+ red cells than that for A+ red cells across all temperatures tested (4 °C, room temperature (RT) and 37 °C). This was also found for AHG phase. Anti-IH was ruled out based on agglutination of O+ cord cells (CCs). Antibody was determined as IgM anti-H after DTT treatment. Three batches of 10 A+ red cells from random donors were tested with three consecutive serums for crossmatching using tube method. Interestingly, out of thirty A+ red cells tested, 20 cells at RT, 11 cells at 37 °C and 11 cells in the AHG phase showed reactivity of greater than 2+. The patient was transfused with 6 units of packed RBCs subsequently. Chemotherapy (R-CHOP regimen) and Helicobacter pylori eradication were then started. Her antibody titer gradually decreased following such treatment. In conclusion, we identified a case of patient with high titer anti-H with broad thermal amplitude, suggesting that anti-H antibodies might need to be considered for cases with pan-agglutination in AST and IDT.

Clinical significance of Rh antigen typing detection for patients who require blood transfusions repeatedly / 中国免疫学杂志

Objective:The Rh antigen typing and antibody identification results of the patients whose irregular antibody screening positive were analyzed,to explore the clinical significance of detecting the Rh antigens typing before the first blood transfusion of the patients who require multiple blood transfusions.Methods:The Rh antigenic typing of 128 irregular antibody screening positive patients were tested by test tube method.The monospecific antibody were identified by microcolumn gel method.Results: Of the 128 patients with irregular antibody screening positive,there were 77 cases in Rh system,including 72 cases of anti-E and 5 cases of anti-c. There were 14 cases of MNSs system,including 10 cases of anti-M and 4 cases of anti-Mur.There were 15 cases of anti-Leain Lewis system.There were 4 cases of anti-P1in P system and 18 cases of other nonspecific antibodies.The distribution of Rh antigen detection was DCCee(74 cases)> DCcEe(34 cases)> DCcee(10 cases)> DccEE(5 cases)> DccEe(2 cases)> DCcEE(1 case),dCcee(1 case),dccee(1 case).The majority phenotype of Rh system antibodies in patients were DCCee.The patients were mainly distributed in the wards who require repeated blood transfusions such as the department of blood internal medicine(26 cases),digestive internal medicine(11 cases),ICU(4 cases).Conclusion:Before the first blood transfusion,we detect the Rh antigenic typing and choose the same antigen phenotype of Rh system for the patients who require blood transfusions repeatedly,which can avoid producing the irregular antibodies in this system,and then to ensure the safety and effective of the blood transfusion.

Investigation of irregular antibodies in blood samples from donors in Shanghai area / 中国输血杂志

Objective With the purpose of further improving blood safety and providing the reference basis for a strategy suitable for large-scale routine screening of irregular antibodies in blood service,the irregular antibodies in blood samples from donors in Shanghai area were investigated.Method Irregular blood antibodies were screened in 824 072 blood donors through combined method of saline medium and microplate papain.Result 1 246 samples of blood donors were detected with irregular antibodies among the total 824 072 samples which indicate the positive rate of 1.51‰.Conclusion Screening of irregular antibodies in blood samples from donors can effectively reduce or avoid hemolytic transfusion reactions.The combined method of saline medium and microplate papain is an effective method for large-scale routine screening of irregular antibodies in blood service.

Correlation analysis between blood typing test,irregular antibody screening of pregnant women and hemolytic disease of newborn / 中国基层医药

Objective To analyze the correlation between the blood typing test,irregular antibodies screening of pregnant women and hemolytic disease of newborn(HDN).Methods The ABO blood type and Rh(D)blood type of pregnant women were detected,and the irregular antibodies of pregnant women were screened.The blood type serol-ogy and hemolytic disease were detected in neonates with jaundice.Results In specimens of 2 032 pregnant women with type O blood,their husbands were non -O blood type,after delivery,152 neonates were diagnosed as HDN. Among 2 032 pregnant women with type non -O blood,only 5 neonates were diagnosed as HDN.There was significant difference between the two groups (χ2 =135.4,P <0.01).27 pregnant women with RhD negative type,their hus-bands were RhD positive,after delivery,4 neonates were diagnosed as HDN.Conclusion Pregnant women's blood type and irregular antibody are closely related to neonatal hemolysis disease.So pregnant women's blood type and irregular antibody should be regular project in pregnancy,and so as to prevent neonatal hemolytic anemia caused by blood type of feto -maternal incompatibility.

Analysis of related detections before blood transfusion in tumor patients / 国际检验医学杂志

Objective To investigate the detection situation and distribution of blood typing positive and negative disagree and irregular antibody positive in blood transfusion related tests in tumor patients ,and to make comparative analysis with the data of non‐tumor patients .Methods The results data in 16 760 patients with blood preparation in our hospital from November 2011 to June 2015 were selected and divided into the tumor patients group and the non‐tumor patients group .Among them ,the results of blood typing positive and negative disagree and positive in the irregular antibody screening test were statistically analyzed .Results 27 cases were ABO blood type positive typing inconsistent with reverse typing ,the occurrence rate of the tumor patients group was 0 .65% ,which of the non‐tumor patients group was 0 .08% ;the irregular antibody positive was in 49 cases ,in which 18 cases were in the tumor patients group with the occurrence rate of 0 .74% ,31 cases were in the non‐tumor patients group witht e occurrence rate of 0 .22% ,showing that the occurrence proportion of blood typing positive and reverse inconsistency and irregular antigen posi‐tive was higher than that of the non‐tumor patients group ,the difference was statistically significant (P<0 .05) ,31 cases in the non‐cancer group ,the positive rate is 0 .22% .18 cases in cancer‐group with 0 .74% incidence rate .It shows that the proportion of posi‐tive in cancer patients was higher than non‐cancer patients (P<0 .05) .The main influencing factors affecting blood typing problems in the tumor patients group and non‐tumor patients group were the antibody weakening ,followed by autoantibody ,etc .the reasons for the irregular antibody screening positive in the two groups were mainly the specific antibodies .Conclusion The disease charac‐teristics of tumor patients are easier to cause ABO blood type positive and reverse inconsistency and irregular antibody screening positive .In the work ,more attention should be paid to the detection results for avoiding the missed detection ,increasing the identifi‐cation ability and ensuring the blood transfusion safety .determination is more often in cancer patients about Tests about blood transfusion ;This should be relate to character of phymatosis .Much concern should be given to related test of cancer patients′blood transfusion ,avoiding omissions ,and improve the safety of blood infusion .

Combinative application CD4+ CD25+ regulatory T cells test and irregular antibody screening in the diagnosis of invalid clinical transfusion / 中国综合临床

Objective To investigate whether the T cells (CD4+ CD25+) levels and the irregular antibodies screening cloud improve the diagnosis of invalid red blood cells transfusion.Methods Thirty-one patients with red blood cell invalid transfusion in the People's Hospital of Yubei District of Chongqing were selected.Flow cytometry was used to detect the changes of CD4+CD25+ regulatory T cells.Standard cells Ⅰ,Ⅱ,Ⅲ were used to screen on irregular antibodies in red blood cells (RBC).Results The rate of invalid RBC transfusion was 7.52％ (31/412) in Yubei District.The incidence rate of medical diseases was 77.42％ (24/31),much higher than surgical disease (22.58％ (7/31,P =0.002),and the major departments were oncology department,hematological department and infectious department.The CD4+ CD25+ regulatory T cells were decrease from (22.18±1.58) ％ to (16.57±1.77) ％(P=0.023).Conclusion Combin CD4+CD25+ regulatory T cells test and irregular antibody screening can help prevent and reduce the invalid transfusionof red blood cells.