红细胞血型抗原拓展匹配适用范围中国专家共识

doi:10.3969/j.issn.1671-2587.2024.03.001

临床输血与检验 ›› 2024, Vol. 26 ›› Issue (3): 289-298.DOI: 10.3969/j.issn.1671-2587.2024.03.001

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红细胞血型抗原拓展匹配适用范围中国专家共识

红细胞血型抗原拓展匹配适用范围中国专家共识编写组

收稿日期:2024-05-19 出版日期:2024-06-20 发布日期:2024-06-24
通讯作者: 于洋（解放军总医院第一医学中心输血医学科）,主要从事输血相容性检测新技术、单采治疗、野战输血及智能化输血辅助策略系统研究,（E-mail）yuyangpla301@163.com。共同通信作者：向东（上海市血液中心）,主要从事输血相容性检测血型参比相关研究,（E-mail）xiangdong@sbc.org.cn。共同通信作者：许先国（浙江省血液中心）,主要从事免疫血液学研究,（E-mail）YJ s001@163.com。
作者简介:李小飞（首都医科大学附属北京友谊医院输血科）,马春娅（解放军总医院第一医学中心输血医学科）,蔡晓红（上海交通大学医学院附属瑞金医院临床输血科）

Chinese Expert Consensus on Red Blood Cell Antigen Extended Matching Range

Expert consensus drafting group of red blood cell antigen extended matching range

Received:2024-05-19 Online:2024-06-20 Published:2024-06-24

摘要/Abstract

摘要： 红细胞同种抗体会增加交叉配血的难度,导致患者红细胞输注延迟,甚至发生输注无效或急性溶血反应。红细胞同种抗体的产生概率大约在0.38%~2.38%,一些需要长期输血的患者（包括血液病等）抗体产生概率则更高,极大地增加了筛选到相合血液的难度及检测成本。如何有效预防红细胞同种抗体的产生,实现快速选择相合血液成分且能同时兼顾输注疗效与安全,一直是困扰临床输血工作者的难点问题之一。红细胞血型抗原拓展匹配是减少红细胞同种免疫机率的有效策略。本共识经国内输血医学和血液病学领域167位专家共同深入探讨后完成,旨在进一步规范红细胞输注时血型抗原拓展匹配的适用范围,为实现红细胞精准输注,提高输注疗效和安全提供技术支撑。

关键词: 红细胞, 血型抗原, 拓展匹配, 输血, 专家共识

中图分类号:

R457

红细胞血型抗原拓展匹配适用范围中国专家共识编写组. 红细胞血型抗原拓展匹配适用范围中国专家共识[J]. 临床输血与检验, 2024, 26(3): 289-298.

Expert consensus drafting group of red blood cell antigen extended matching range. Chinese Expert Consensus on Red Blood Cell Antigen Extended Matching Range[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2024, 26(3): 289-298.

参考文献

[1] 国家卫生健康委员会.输血相容性检测标准[S].2022.
[2] 蓝燕飞,钟明璐,陈小洁,等.红细胞Rh血型相容性输血临床意义与经济性分析[J].临床输血与检验,2023,25(6):783-788.
[3] RADWANSKI K,GARRAUD O,COGNASSE F,et al.The effects of red blood cell preparation method on in vitro markers of red blood cell aging and inflammatory response[J].Transfusion,2013,53(12):3128-3138.
[4] HENDRICKSON J E,TORMEY C A.Understanding red blood cell alloimmunization triggers[J].Hematology Am Soc Hematol Educ Program,2016,2016(1):446-451.
[5] 林裕翔,许志远,蓝尹骏,等.北京地区人群红细胞抗体免疫病患发生新增抗体的累积发生率[J].中国输血杂志,2019,32(10):1021-1023.
[6] 李淑婷,张红星,王健.Rh表型匹配输注在自身抗体阳性患者输血中的应用价值[J].实用医技杂志,2022,29(7):723-727.
[7] CAMPBELL-LEE S A,GVOZDJAN K,CHOI K M,et al.Red blood cell alloimmunization in sickle cell disease:assessment of transfusion protocols during two time periods[J].Transfusion,2018,58(7):1588-1596.
[8] TORMEY C A,HENDRICKSON J E.Transfusion-related red blood cell alloantibodies:induction and consequences[J].Blood,2019,133(17):1821-1830.
[9] 王谦,燕备战,于洋.31766名患者红细胞血型不规则抗体分析[J].中国输血杂志,2011,24(11):966-968.
[10] 曹微微,舒象武,李碧娟,等.55481例住院拟输血患者红细胞血型不规则抗体分析[J].临床输血与检验,2013,15(3):238-240.
[11] YU Y,WANG Y,SUN X L,et al.Prevalence and specificity of red blood cell alloantibodies in patients from China during 1994-2013[J].Zhongguo Shi Yan Xue Ye Xue Za Zhi,2015,23(6):1734-1741.
[12] WANG Q S,YANG Q N,BAI Y Z,et al.Frequency of RBC alloantibodies in Chinese surgical patients[J].Transfus Med Hemother,2012,39(4):283-286.
[13] CHEN C X,TAN J Z,WANG L X,et al.Unexpected red blood cell antibody distributions in Chinese people by a systematic literature review[J].Transfusion,2016,56(4):975-979.
[14] MO Z,LI H,HUANG L,et al.Prevalence and specificity of RBC alloantibodies in the general hospitalised population in Guangxi[J].Transfus Med,2015,25(5):313-319.
[15] 洪毅,李菲,杨阳,等.56510例患者不规则抗体及特异性检测结果分析[J].海南医学,2021,32(2):222-224.
[16] 杨晓华,李玉秋,张慧娴,等.Rh和MNS血型系统临床输血患者不规则抗体的分布特点及意义[J].河北医药,2022,44(3):453-455.
[17] 许亚莉,吴继博,徐华,等.多中心联合筛查红细胞血型不规则抗体的大数据分析[J].中国输血杂志,2018,31(8):823-825.
[18] POLITOU M,VALSAMI S,DRYLLIS G,et al.Retrospective study on prevalence,specificity,sex,and age distribution of alloimmunization in two general hospitals in Athens[J].Turk J Haematol,2020,37(3):154-166.
[19] EVERS D,MIDDELBURG R A,HAAS M D,et al.Red-blood-cell alloimmunisation in relation to antigens' exposure and their immunogenicity:a cohort study[J].Lancet Haematol,2016,3(6):e284-e292.
[20] WINTERS J L,PINEDA A A,GORDEN L D,et al.RBC alloantibody specificity and antigen potency in Olmsted County,Minnesota[J].Transfusion,2001,41(11):1413-1420.
[21] SPANOS T,KARAGEORGA M,LADIS V,et al.Red cell alloantibodies in patients with thalasseMi^a[J].Vox Sang,1990,58(1):50-55.
[22] 张保萍,张嵘,王文婷,等.谱细胞鉴定剂量效应分析偏差致抗-C抗体漏检1例[J].临床输血与检验,2021,23(2):236-239.
[23] 孙晓琳,于洋,关晓珍,等.“剂量效应” 现象对意外抗体鉴定的影响[J].中国实验血液学杂志,2015,23(1):222-227.
[24] 陈春霞,魏曾珍,谭金哲,等.国内抗体筛查细胞试剂比对[J].中国输血杂志,2017,30(11):1243-1245.
[25] 向东,范亮峰,刘曦,等.免疫性溶血性输血反应100例分析[J].临床输血与检验,2022,24(1):11-15.
[26] SCHONEWILLE H,VAN DE WATERING L M G,BRAND A.Additional red blood cell alloantibodies after blood transfusions in a nonhematologic alloimmunized patient cohort:is it time to take precautionary measures?[J].Transfusion,2006,46(4):630-635.
[27] 崔颖,张勇萍,杨世明,等.不规则抗体筛选与特异性鉴定的影响因素及其对策分析[J].细胞与分子免疫学杂志,2022,38(2):165-170.
[28] TORMEY C A,STACK G.Immunogenicity of blood group antigens:a mathematical model corrected for antibody evanescence with exclusion of naturally occurring and pregnancy-related antibodies[J].Blood,2009,114(19):4279-4282.
[29] STACK G,TORMEY C A.Estimating the immunogenicit y of blood group antigens:a modified calculation that corrects for transfusion exposures[J].Br J Haematol,2016,175(1):154-160.
[30] AMEEN R,SHEMMARI S A,AL-BASHIR A.Red blood cell alloimmunization among sickle cell Kuwaiti Arab patients who received red blood cell transfusion[J].Transfusion,2009,49(8):1649-1654.
[31] FASANO R M,BOOTH G S,MILES M,et al.Red blood cell alloimmunization is influenced by recipient inflammatory state at time of transfusion in patients with sickle cell disease[J].Br J Haematol,2015,168(2):291-300.
[32] CHOU S T,JACKSON T,VEGE S,et al.High prevalence of red blood cell alloimmunization in sickle cell disease despite transfusion from Rh-matched minority donors[J].Blood,2013,122(6):1062-1071.
[33] CASTRO O,SANDLER S G,HOUSTON-YU P,et al.Predicting the effect of transfusing only phenotype-matched RBCs to patients with sickle cell disease:theoretical and practical implications[J].Transfusion,2002,42(6):684-690.
[34] ROMPHRUK A V,BUTRYOJANTHO C,JIRASAKONPA T B,et al.Phenotype frequencies of Rh (C,c,E,E),M,Mi^a and Kidd blood group systems among ethnic Thai blood donors from the north-east of Thailand[J].Int J Immunogenet,2019,46(3):160-165.
[35] 深圳市医师协会输血科医师分会.Rh血型相容性输血指南[S].深圳市医师协会. 2021
[36] 江西省输血协会.江西省Rh血型相容性输血专家共识[S].2022.
[37] 四川省医师协会输血科医师分会.Rh血型相容性输血指南(试行)[S].2023.
[38] 青岛市医学会输血医学专科分会.Rh血型相容性输血指南(试行)[S].2021.
[39] 广东省医院协会.Rh血型抗原检测应用标准[S].2023.
[40] TAHHAN H R,HOLBROOK C T,BRADDY L R,et al.Antigen-matched donor blood in the transfusion management of patients with sickle cell disease[J].Transfusion,1994,34(7):562-569.
[41] NOOR HASLINA M N,ARIFFIN N,ILLUNI HAYATI I,et al.Red cell immunization in multiply transfused Malay thalassemic patients[J].Southeast Asian J Trop Med Public Health,2006,37(5):1015-1020.
[42] ZAIDI U,BORHANY M,ANSARI S,et al.Red cell alloimmunisation in regularly transfused beta thalasseMi^a patients in Pakistan[J].Transfus Med,2015,25(2):106-110.
[43] 施艺璇,何苏英,彭永正.电子匹配信息系统辅助的Rh血型五抗原配合性输注的安全性和有效性研究[J].临床输血与检验,2023,25(3):379-383.
[44] ZHANG Y,LI X F.Is antigen-negative matching strategy in non-ABO blood system between donors and recipients a practical reality?[J].Transfus Clin Biol,2023,30(2):184-185.
[45] AMEEN R,AL-SHEMMARI S,AL-HUMOOD S,et al.RBC alloimmunization and autoimmunization among transfusion-dependent Arab thalasseMi^a patients[J].Transfusion,2003,43(11):1604-1610.
[46] RIBEIRO K R,GUARNIERI M H,DA COSTA D C,et al.DNA array analysis for red blood cell antigens facilitates the transfusion support with antigen-matched blood in patients with sickle cell disease[J].Vox Sang,2009,97(2):147-152.
[47] YANG Q X,LI A J,WANG C,et al.Fully genotyping and screening of clinically important blood-group antigens by MALDI TOF mass spectrometry[J].Electrophoresis,2024,45(5/6):548-556.
[48] FÜRST D,TSAMADOU C,NEUCHEL C,et al.Next-generation sequencing technologies in blood group typing[J].Transfus Med Hemother,2020,47(1):4-13.
[49] ROPHINA M,PANDHARE K,JADHAO S,et al.BGvar:a comprehensive resource for blood group immunogenetics[J].Transfus Med,2022,32(3):229-236.
[50] PATNAIK S K,BLUMENFELD O O.Patterns of human genetic variation inferred from comparative analysis of allelic mutations in blood group antigen genes[J].Hum Mutat,2011,32(3):263-271.
[51] WHEELER C A,CALHOUN L,BLACKALL D P.Warm reactive autoantibodies:clinical and serologic correlations[J].Am J Clin Pathol,2004,122(5):680-685.
[52] BLACKALL D P,WHEELER C A.Contemporaneous autoantibodies and alloantibodies[J].Transfusion,2007,47(7):1332.
[53] DELANEY M,APELSETH T O,BONET BUB C,et al.Red-blood-cell alloimmunization and prophylactic antigen matching for transfusion in patients with warm autoantibodies[J].Vox Sang,2020,115(6):515-524.
[54] ZIMAN A,COHN C,CAREY P M,et al.Warm-reactive (immunoglobulin G) autoantibodies and laboratory testing best practices:review of the literature and survey of current practice[J].Transfusion,2017,57(2):463-477.
[55] 王雨涵,王华,王洁,等.RhCcEe抗原配合性悬浮红细胞输注在温抗体型AIHA患者紧急输血中的应用[J].四川医学,2021,42(1):31-34.
[56] 邵超鹏,骆群,伍昌林.输血依赖型地中海贫血(TDT)患者临床输血中国专家共识[J].临床输血与检验,2023,25(2):163-169.
[57] 杨政道,赵鼎,田冬冬.β-地中海贫血患者长期红细胞输注中应用RhCcEe抗原配合性输血策略的应用效果评估[J].中国医学工程,2021,29(5):36-39.
[58] 王雨涵,王华,王洁,等.RhCcEe抗原配合性输血在β-地中海贫血患者血液输注中的应用[J].中国输血杂志,2019,32(4):349-351.
[59] ORTIZ S,ORERO M T,JAVIER K,et al.Impact of azacitidine on red blood cell alloimmunisation in myelodysplastic syndrome[J].Trasfusione Del Sangue,2017,15(5):472-477.
[60] GUELSIN G A S,RODRIGUES C,VISENTAINER J E L,et al.Molecular matching for Rh and K reduces red blood cell alloimmunisation in patients with myelodysplastic syndrome[J].Blood Transfus,2015,13(1):53-58.
[61] LIN Y,SASKIN A,WELLS R A,et al.Prophylactic RhCE and Kell antigen matching:impact on alloimmunization in transfusion-dependent patients with myelodysplastic syndromes[J].Vox Sang,2017,112(1):79-86.
[62] 江灵,王华,王静,等.RhCcEe抗原配合性输血在多次输血患者中的应用[J].医学信息,2022,35(9):168-170.
[63] 王书亚,孔永奎,王莉,等.Rh分型同型输注对于反复输血患者的必要性分析[J].郑州大学学报(医学版),2021,56(4):555-559.
[64] OUD J A,EVERS D,HAAS M D,et al.The effect of extended c,E and K matching in females under 45 years of age on the incidence of transfusion-induced red blood cell alloimmunisation[J].Br J Haematol,2021,195(4):604-611.
[65] BODNAR M,LIEBERMAN L,ARSENAULT V,et al.The selection and preparation of red cell components for intrauterine transfusion:a national survey[J].Vox Sang,2024,119(3):265-271.
[66] DOYLE B,QUIGLEY J,LAMBERT M,et al.Red cell alloimmunisation following intrauterine transfusion and the feasibility of providing extended phenotype-matched red cell units[J].Transfus Med,2014,24(5):311-315.
[67] WONG K,LAI W K,JACKSON D E.HLA Class II regulation of immune response in sickle cell disease patients:susceptibility to red blood cell alloimmunization (systematic review and meta-analysis)[J].Vox Sang,2022,117(11):1251-1261.

红细胞血型抗原拓展匹配适用范围中国专家共识

Chinese Expert Consensus on Red Blood Cell Antigen Extended Matching Range

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