自身免疫性溶血性贫血的输血支持和输血前检测。

IF 1.8 4区医学 Q3 HEMATOLOGY

Vox Sanguinis Pub Date : 2024-06-23 DOI:10.1111/vox.13699

Marilène Binsfeld, Anaïs Devey, André Gothot

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引用次数: 0

摘要

自身免疫性溶血性贫血（AIHA）的特点是由于免疫功能障碍和自身抗体的产生导致红细胞破坏增加。临床表现主要与贫血有关，急性溶血时可危及生命。为了缓解严重贫血，对这些患者的支持性治疗通常包括输血。遗憾的是，游离血清自身抗体会对输血前检测造成极大干扰，因此为 AIHA 患者鉴定相容的红细胞单位是一项挑战，甚至是不可能的。输血前检测中遇到的问题往往导致 AIHA 患者推迟或放弃输血。在这篇综述中，我们讨论了有关 AIHA 全球输血管理的出版物，重点是输血前检测，以及管理这些患者输血单位选择的实用线索。根据输血的紧急程度，我们提出了一种为 AIHA 患者选择输血单位并进行实验室检测的算法。

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Transfusion support and pre-transfusion testing in autoimmune haemolytic anaemia.

Autoimmune haemolytic anaemia (AIHA) is characterized by an increased destruction of red blood cells due to immune dysfunction and auto-antibody production. Clinical manifestations are mainly related to anaemia, which can become life-threatening in case of acute haemolysis. Aiming at counterbalancing severe anaemia, supportive treatments for these patients frequently include transfusions. Unfortunately, free serum auto-antibodies greatly interfere in pre-transfusion testing, and the identification of compatible red blood cell units for AIHA patients can be challenging or even impossible. Problems faced in pre-transfusion testing often lead to delay or abandonment of transfusions for AIHA patients. In this review, we discuss publications concerning global transfusion management in AIHA, with a focus on pre-transfusion testing, and practical clues to manage the selection of transfusion units for these patients. Depending on the degree of transfusion emergency, we propose an algorithm for the selection and laboratory testing of units to be transfused to AIHA patients.

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来源期刊

Vox Sanguinis 医学-血液学

CiteScore

4.40

自引率

11.10%

发文量

156

审稿时长

6-12 weeks

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.