RISK OF RED BLOOD CELL ALLOIMMUNISATION IN RWANDA: ASSESSMENT OF PRETRANSFUSION CROSSMATCH TECHNIQUES USED IN DISTRICT HOSPITALS.

Q4 Medicine

East African medical journal Pub Date : 2013-04-01 DOI:10.4314/EAMJ.V90I4

E. Ndahimana, A. Gothot, C. Gérard, F. Senyana, S. R'Zik, O. Mukabayire, L. Mutesa

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引用次数: 5

Abstract

BACKGROUND Screening of alloantibodies in patients is not yet done in district hospitals of Rwanda. The practice is to transfuse ABO/D compatible blood following an immediate spin crossmatch (IS-XM) or indirect antiglobulin test crossmatch (IAT-XM). OBJECTIVES To assess the risk of red blood cell (RBC) alloimmunisation associated with the use of IS-XM compared to the IAT-XM in patients receiving blood transfusions in district hospitals in Rwanda. DESIGN A cross-sectional comparative descriptive study. SETTING Four Rwandan district hospitals. Kirehe and Nyanza hospitals used IS-XM while Muhima and Ruhengeri hospitals used IAT-XM. SUBJECTS Blood samples were obtained from 187 patients (101 with IS-XM and 86 with IAT-XM) transfused in January, February, October, and November of 2012. RESULTS The median age of blood recipients was 31 years (7 - 80) and 36% of them were male. Sixteen specific antibodies were identified in 12 patients: anti-RH1/D (2),anti-RH2/C (2), anti-RH3/E (2), anti-RH4/c (1), anti-RH5/e (2),anti-LE1/Lea (2),anti-JK1/Jka (1), anti-JK2/Jkb (1), anti-KEL1/K (1), anti-MNS1/M (1), and autoantibody (1).The global prevalence of redblood cell (RBC) alloimmunisationwas 6.4% (12/187). Thatprevalence was significantly higher in the IS-XM group (10.4%) than in the IAT-XM group (2.3%) with an odds ratio of 4.8; [95% CI=1.2-19.8]; and a p-value of 0.031. CONCLUSION The prevalence of red blood cell (RBC) alloimmunisation in 187 patients receiving blood transfusions was 6.4% and was higher in recipients from hospitals using IS-XM, with Rhesus (RH) system antibodies widely predominant (56.2%).We recommend that IAT-XM be used in all district hospitals in Rwanda to minimise this risk.

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卢旺达红细胞同种免疫的风险:对地区医院使用的输血前交叉配型技术的评估。

背景:卢旺达地区医院尚未对患者进行同种异体抗体筛查。做法是在立即旋转交叉配型(is - xm)或间接抗球蛋白试验交叉配型(IAT-XM)后输入ABO/D相容血。目的评估卢旺达地区医院接受输血的患者使用IS-XM与使用IAT-XM相关的红细胞(RBC)同种免疫的风险。设计横断面比较描述性研究。设置四所卢旺达地区医院。Kirehe和Nyanza医院使用IS-XM, Muhima和Ruhengeri医院使用IAT-XM。研究对象于2012年1月、2月、10月和11月对187例患者进行输血，其中101例为IS-XM, 86例为IAT-XM。结果受血者年龄中位数为31岁(7 ~ 80岁)，男性占36%。12例患者共检出抗rh1 /D(2)、抗rh2 /C(2)、抗rh3 /E(2)、抗rh4 /C(1)、抗rh5 /E(2)、抗le1 /Lea(2)、抗jk1 /Jka(1)、抗jk2 /Jkb(1)、抗kel1 /K(1)、抗mns1 /M(1)、自身抗体(1)等16种特异性抗体，全球红细胞异体免疫率为6.4%(12/187)。IS-XM组的患病率(10.4%)显著高于IAT-XM组(2.3%)，优势比为4.8;(95% CI = 1.2 - -19.8);p值为0.031。结论187例接受IS-XM输血的患者红细胞异体免疫阳性率为6.4%，接受IS-XM输血的患者较高，其中恒河猴(RH)系统抗体广泛占优势(56.2%)。我们建议卢旺达所有地区医院都使用IAT-XM，以尽量减少这种风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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East African medical journal Medicine-Medicine (all)

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期刊介绍： The East African Medical Journal is published every month. It is intended for publication of papers on original work and reviews of all aspects of medicine. Communications bearing on clinical and basic research on problems relevant to East Africa and other African countries will receive special attention. Papers submitted for publication are accepted only on the understanding they will not be published elsewhere without the permission of the Editor-in-Chief