对血液警戒报告的分析显示，12.5%的急性溶血性输血反应是由低发病率抗原的抗体引起的。

IF 1.6 4区医学 Q3 HEMATOLOGY

Vox Sanguinis Pub Date : 2025-09-01 Epub Date: 2025-08-03 DOI:10.1111/vox.70068

Holly Elizabeth Perry, William Nicholas Charles Perry

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引用次数: 0

摘要

背景和目的：许多输血中心不再对没有临床意义的红细胞异体抗体的患者进行抗球蛋白交叉配型，而是使用简短的交叉配型。这一政策带来了许多好处，但也存在溶血性输血反应（HTRs）的风险。由未检测到的低发生率抗原（LIAs）抗体引起的反应的历史估计在每500,000次红细胞输注中有1次反应。这项血液警戒报告的荟萃分析比较了历史估计和记录事件。材料和方法：本研究分析了2006年至2022年间来自四个国家的血液警戒报告中发表的255例急性HTR （AHTR）和385例延迟HTR （DHTR）。结果：每个国家每10万个发放/输注的红细胞的htr率（急性+延迟）从0.75到4.46不等。引起AHTRs的大多数抗体（59.6%）是未鉴定的。针对LIAs的抗体占AHTRs的12.5% (n = 32)，其中59.4% （n = 19）被鉴定为抗wra （Diego系统中的DI3）。值得注意的是，有一个致命的反应可能是由anti-Wra引起的。LIAs抗体仅占DHTRs的1.6%，其他血型系统的抗体是主要原因，特别是Rh和Kidd系统。结论：本研究计算的LIAs未检出抗体引起HTRs的风险在每100万次红细胞输注1次反应范围内。

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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Analysis of haemovigilance reports reveals 12.5% of acute haemolytic transfusion reactions are attributed to antibodies to low-incidence antigens.

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-Wr^a (DI3 in the Diego system). Of note was one fatal reaction likely attributable to anti-Wr^a. 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.

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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.