Holly Elizabeth Perry, William Nicholas Charles Perry
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引用次数: 0
Abstract
Background and objectives: Many transfusion centres no longer perform an antiglobulin crossmatch on patients without clinically significant red cell alloantibodies, but instead use an abbreviated crossmatch. This policy brings many benefits but has an acknowledged risk of haemolytic transfusion reactions (HTRs). Historical estimates of reactions caused by undetected antibodies to low-incidence antigens (LIAs) were in the region of 1 reaction per 500,000 red cell transfusions. This meta-analysis of haemovigilance reports compares historical estimates with recorded events.
Materials and methods: This study analysed 255 acute HTR (AHTR) and 385 delayed HTR (DHTR) published in haemovigilance reports from four countries between 2006 and 2022.
Results: The rate of HTRs (acute + delayed) per 100,000 red cells issued/transfused varied from 0.75 to 4.46 by country. The majority of antibodies (59.6%) causing AHTRs were uncharacterized. Antibodies to LIAs accounted for 12.5% (n = 32) of AHTRs, and of these, 59.4% (n = 19) were identified as anti-Wra (DI3 in the Diego system). Of note was one fatal reaction likely attributable to anti-Wra. Antibodies to LIAs accounted for only 1.6% of DHTRs, where antibodies from other blood group systems were responsible, notably in the Rh and Kidd systems.
Conclusion: The risk of HTRs caused by undetected antibodies to LIAs calculated in this study is in the region of 1 reaction per 1 million red cell transfusions.
期刊介绍：
Vox Sanguinis reports on important, novel developments in transfusion medicine. Original papers, reviews and international fora are published on all aspects of blood transfusion and tissue transplantation, comprising five main sections:
1) Transfusion - Transmitted Disease and its Prevention:
Identification and epidemiology of infectious agents transmissible by blood;
Bacterial contamination of blood components;
Donor recruitment and selection methods;
Pathogen inactivation.
2) Blood Component Collection and Production:
Blood collection methods and devices (including apheresis);
Plasma fractionation techniques and plasma derivatives;
Preparation of labile blood components;
Inventory management;
Hematopoietic progenitor cell collection and storage;
Collection and storage of tissues;
Quality management and good manufacturing practice;
Automation and information technology.
3) Transfusion Medicine and New Therapies:
Transfusion thresholds and audits;
Haemovigilance;
Clinical trials regarding appropriate haemotherapy;
Non-infectious adverse affects of transfusion;
Therapeutic apheresis;
Support of transplant patients;
Gene therapy and immunotherapy.
4) Immunohaematology and Immunogenetics:
Autoimmunity in haematology;
Alloimmunity of blood;
Pre-transfusion testing;
Immunodiagnostics;
Immunobiology;
Complement in immunohaematology;
Blood typing reagents;
Genetic markers of blood cells and serum proteins: polymorphisms and function;
Genetic markers and disease;
Parentage testing and forensic immunohaematology.
5) Cellular Therapy:
Cell-based therapies;
Stem cell sources;
Stem cell processing and storage;
Stem cell products;
Stem cell plasticity;
Regenerative medicine with cells;
Cellular immunotherapy;
Molecular therapy;
Gene therapy.
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