Pre-clinical blood transfusion testing in medical institutions is the most crucial inspection link in the clinical blood transfusion process. High-quality clinical pre-transfusion detection techniques and capabilities can minimize the risk of adverse reactions to blood transfusion to the greatest extent. Since the test results before clinical blood transfusion are the definitive diagnosis for the recipient (patient), whether the safety and effectiveness of blood transfusion can be ensured often depends on the accuracy and timeliness of the test results. Therefore, in order to ensure the safety and effectiveness of clinical blood transfusion, and to safeguard people's health and social stability, the expert consensus group has gathered experts and scholars in the field of clinical blood transfusion medicine and related disciplines in China. They have combined national laws and regulations, standardized documents, national health standards related to blood transfusion, and research results related to clinical blood transfusion to formulate this expert consensus. The aim is to further standardize the use of key equipment and reagents for pre-transfusion testing in the blood transfusion department (blood bank), as well as the detection capabilities of personnel.

Transfusion medicine is undergoing a significant transformation from traditional empirical medicine to modern precision medicine. This article systematically reviews the development of transfusion medicine from two dimensions: hardware (blood component research) and software (management system). The evolution encompasses three stages: the 1.0 cognitive initiation phase characterized by blood typing and whole blood transfusion, the 2.0 development phase marked by blood component preparation and standardized management, and the current 3.0 innovation phase featuring intelligence and personalization. In the 3.0 era, gene editing technology has facilitated the development of universal blood, the directed differentiation of stem cells has enabled the in vitro culture of blood cells, and the introduction of artificial intelligence has optimized transfusion decision-making and blood management. These technological innovations are driving transfusion medicine into a new era of precision medicine. This article provides an in-depth analysis of emerging technologies' applications in transfusion medicine and explores the opportunities and challenges brought by multidisciplinary integration, offering new perspectives for the future development of transfusion medicine.

Objective To understand the distribution of RhD, C, c, E and e antigens among Chinese people in China, and to explore the genetic relationships of Rh blood type distribution across different regions and ethnic groups. Methods Data on the distribution of RhD, C, c, E, and e antigens from 1 048 519 Chinese individuals across 34 provinces, municipalities directly under the Central Government, and autonomous regions were collected for population genetic analysis. The maximum likelihood method was used to calculate the Rh gene frequency and haplotype frequency. The reliability of the data was evaluated by the Hardy-Weinberg equilibrium fit test. Results The distribution of Rh blood type in 34 provinces, municipalities and autonomous regions and 16 ethnic groups in China was consistent with Hardy-Weinberg equilibrium. The allele frequencies of RHD and RHCE, as well as the Rh haplotype frequencies, were associated with the subjects' place of origin. Among northerners and southerners, the RhD-positive rates were 99.55% and 99.61% respectively, and the RhD-negative rates were 0.45% and 0.39% respectively. The frequencies of DCe haplotype with Asian characteristics were 0.625 9 and 0.683 5, and the frequencies of the RHCE*Ce allele were 0.641 6 and 0.701 4, respectively. Conclusion The data analyzed in this report were collected nationwide using uniform standards, with over one million subjects examined. The derived data obtained through analysis can be used as control data for various regions in China and used in disease association studies, anthropological studies, and transfusion medicine research.

Objective To estimate the probability of RhCE antigen mismatch in random blood transfusions and establish a RhCE typing strategy suitable for patients in China. Methods The RhCE antigen mismatch between donor and recipient were determined by Landsteiner's rule. The calculation of mismatch probability and the chance of finding a matching donor were determined by the genetic parameters of Rh blood type in Chinese individuals. Results The Rh antigen distribution data of 1.04 million subjects were analyzed according to their place of origin and ethnicity. In northerners and southerners, the probabilities of RhD antigen mismatch in random blood transfusions, were 0.45% and 0.39%, respectively; The probabilities of RhCE antigen mismatch were antigen 26.31% and 23.60%, respectively; and the probability of RhCE antigen mismatch were 58.73 and 60.75 times higher than those of RhD antigen mismatch, respectively; DCCee is a high-risk phenotype for mismatching, accounting for 56.01% to 62.33% of all mismatching. A blood bank with about 100 donors can provide RhCE antigen-matched blood to 98% of Chinese patients. Conclusion In patients receiving RhD matched blood transfusions, the probability of RhCE antigen mismatch is approximately 25%. The establishment of a RhCE antigen matching strategy suitable for Chinese patients will help optimize individualized and precise blood transfusion.

Objective To explore the effect and mechanism of hydrogen (H₂) on apheresis platelets activation and apoptosis. Methods 10 apheresis platelets were divided equally into 16 small bags and randomly divided into an H₂ group and a control group. The H₂ group was added with hydrogen to saturation and supplemented with hydrogen daily. All samples were stored under agitation at (22±2) ℃ for 8 days, the platelet count was tested, and the CD62P, PAC-1, apoptosis were detected by flow cytometry daily. The Caspase-3, Caspase-9, Bax, and Bcl-2 proteins were detected by Western blotting. Results There was no significant difference in platelet count during the preservation period (1~8 d). From the fifth day, the apoptosis rate in H₂ group was significantly lower than that in the control group (20.29±4.32 vs 33.06±8.01, P<0.001). From the sixth day, the expression of CD62P in H₂ group was lower than that in the control group (24.94±5.53 vs 47.14±10.41, P<0.001), and the expression of PAC-1 in H₂ group was lower than that in the control group (14.89±5.98 vs 19.41±5.17, P<0.05). Western blotting results showed that from the sixth day, the expression of cleaved Caspase-9 and cleaved Caspase-3 in the H₂ group was lower than that in the control group (P<0.001). From the seventh day, the expression of Bax in the H₂ group was lower than that in the control group (P<0.001), while Bcl-2 was higher than that in the control group (P<0.05), the ratio of Bax/Bcl-2 was lower than that of the control group. Conclusion Hydrogen can reduce platelet activation and apoptosis, improve the quality of apheresis platelet storage.

Objective To investigate the regulatory mechanism underlying the effect of acid-sensing ion channel 3 (ASIC3) on the balance between regulatory T (Treg) cells and T helper type 17 (Th17) cells via the Ca²⁺-calcineurin (CaN)-nuclear factor of activated T cells (NFAT) signaling axis. Methods Donor platelets and recipient peripheral blood mononuclear cells (PBMCs) were co-cultured in vitro at a ratio of 250∶1 to simulate the state of platelet transfusion in vitro. By constructing ASIC3 overexpression lentivirus and co-culturing with in vitro cell model, they were divided into three groups: (1) blank control group; (2) negative control lentivirus group; (3) ASIC3 overexpression lentivirus group. The proportion of Treg (Foxp3⁺) and Th17 (IL-17A⁺) cells and intracellular Ca²⁺ level were detected by flow cytometry. The expression of ASIC3, phospholipase CB (PLCB), CaN, NFATC1 and its phosphorylated protein (p-NFATC1) were detected by Western blot. Results Compared with the blank control group, the proportion of Th17 cells in the ASIC3 overexpression lentivirus group was significantly increased (P<0.01), and the proportion of Treg cells was significantly decreased (P<0.05). Intracellular Ca²⁺ concentration increased 1.8 times (P<0.001). Protein detection showed that the expression of PLCB, CaNand p-NFATC1 in ASIC3 overexpression group were significantly up-regulated (all P<0.05). Conclusion ASIC3 overexpression up-regulates the expression of PLCB/CaN/p-NFATC1 by activating the Ca²⁺-CaN-NFAT signaling axis, promotes the continuous activation of NFAT, and then drives IL-17 transcription, eventually leading to Treg/Th17 immune imbalance.

Objective To investigate the clinical application of fresh frozen plasma (FFP) in pediatric patients with sepsis and its association with prognosis. Methods A retrospective analysis was conducted on 262 pediatric patients with sepsis admitted to the PICU of Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology between January 2023 and December 2024. Patients were categorized into an FFP transfusion group and a non-transfusion group based on whether they received FFP during hospitalization. Differences in characteristics, laboratory findings, clinical interventions, and prognostic outcomes between the two groups were compared. Results Significant differences were observed between the transfusion group (n=87) and the non-transfusion group (n=175) in laboratory parameters, including white blood cell count (P=0.007), platelet count (P=0.000), coagulation function (P=0.000), clinical interventions (P=0.000), and prognosis (P=0.000). Multivariate binary logistic regression analysis revealed that FFP transfusion (HR 6.079, 95%CI 1.336-27.661, P=0.020), mechanical ventilation (HR 16.107, 95%CI 4.637-55.949, P=0.000), and PRISM Ⅲ score≥15 (HR 7.865, 95%CI 1.539-40.208, P=0.013) were independent predictors of in-hospital mortality in pediatric patients with sepsis. Additionally, FFP transfusion (HR 3.242, 95%CI 1.277-8.227, P=0.013), lactate dehydrogenase levels (HR 1.001, 95%CI 1.000-1.002, P=0.018), and PRISM Ⅲ score≥15 (HR 5.308, 95%CI 1.420-19.840, P=0.013) were identified as independent predictors of multiple organ dysfunction syndrome (MODS). Except for children over 10 years old, the transfusion group exhibited significantly higher mortality and MODS rates across all age groups (all P<0.05). Notably, children receiving FFP doses>60 mL/kg, frequency>3 times, or FFP infusion within 24 hours demonstrated the highest mortality and MODS rates. Conclusion FFP transfusion is significantly associated with increased in-hospital mortality and MODS occurrence in pediatric patients with sepsis, suggesting that clinicians should evaluate the necessity of FFP administration to reduce its irrational use.

Objective To explore the value of capillary ultracentrifugation for RhCcEe phenotype identification in patients with mixedfield agglutination reaction (MF). Methods A total of 1 155 patients with MF in RhCcEe phenotype identification from December 2020 to April 2024 were enrolled at First Affiliated Hospital of Nanjing Medical University. The young erythrocytes were separated by capillary ultracentrifugation and identified the RhCcEe antigen, then retrospectively analyzed the RhCcEe antigen compatibility of recipients and donors. Results The distribution of Rh blood groups in 995 (86.15%) patients successfully identified by capillary ultracentrifugation was CCDee>CcDEe>ccDEE>CcDee. The proportion of RhCcEe antigen incompatibility transfusion was high (35.41%). When recipients received blood transfusions from multiple donors, their risk of Rh antigen incompatibility transfusion reactions was significantly increased (P<0.001). Conclusion Capillary ultracentrifugation was helpful for identifying Rh blood groups in patients with MF of RhCcEe antigens and provided the basis for compatible blood transfusion

Objective To construct and validate a prediction model for severe hyperbilirubinemia complicating ABO hemolytic disease of the fetus and newborn (ABO-HDNF), providing a basis for timely clinical intervention. Methods Weretrospectively analyzed clinical data from 306 ABO-HDNF infants diagnosed and treated between January 2022 and December 2024. Of these, 204 cases were regarded as the modeling set and 102 the validation set. Patients were stratified into severe and non-severe hyperbilirubinemia groups. Risk factors for severe hyperbilirubinemia were identified through univariate analysis and binary logistic regression. A nomogram model was constructed, with receiver operating characteristic (ROC) and calibration curves evaluating its performance. Clinical utility of the model was further evaluated using a clinical decision curve. Results Univariate and binary logistic regression analyses identified postnatal time at admission (OR=1.303), positive Direct Antiglobulin Test (OR=3.073), eluate agglutination strength (OR=3.189), and total bilirubin/albumin ratio (OR=1.863) as independent risk factors for severe hyperbilirubinemia (P<0.05). The nomogram demonstrated a C-index of 0.790 (95%CI: 0.713~0.867). Area under the curve (AUC) values were 0.790 (95%CI: 0.713~0.867) and 0.754 (95%CI: 0.638~0.871) for modeling and validation sets, respectively. Calibration curves indicated good consistency, and decision curve analysis showed high net clinical benefit. Conclusion The nomogram incorporating postnatal time, Direct Antiglobulin Test results, eluate agglutination strength, and total bilirubin/albumin ratio exhibits favorable predictive performance for severe hyperbilirubinemia complicating ABO-HDNF.

Objective To analyze the effect of different packed red blood cells (pRBCs) volume on the result of acid elution test, for optimizing the sample volume in neonatal hemolytic disease detection. Methods One hundred and fifty specimens with suspected neonatal hemolytic disease were collected from February 2022 to December 2022 for hemolytic triple test. We identified the elution agglutination intensity of specimens confirmed ABO neonatal hemolytic disease under four different pRBCs volume (A: 250 μL, B: 500 μL, C: 750 μL, D: 1 000 μL). Cochran's Q test was used to analyze the differences in overall positive rates among four groups. McNemar's test was applied for multiple comparisons. The Friedman test was used to analyze the differences in the overall distribution of agglutination intensity, and the Wilcoxon test was applied for multiple comparisons. Results In 118 cases of confirmed ABO neonatal hemolytic disease, the positivity rate was 94.92% in group A, and 100% in groups B, C, and D (P<0.05).There was no significant difference in positive rate between group A and groups B/C/D (corrected P>0.008 3). The overall difference (P<0.001) and the multiple comparison difference (P<0.008 3 after correction) in the rank distribution of agglutination intensity for the four groups were statistically significant, and the agglutination intensity increased with the increase of pRBCs volume. Conclusion We can reduce the pRBCs volume from 1 000 μL to 500 μL in acid elution test, ensuring the accuracy of the test results and saving blood sample volume.

Objective To investigate the patterns and characteristics of hemoglobin (Hb) levels in different populations under high-altitude hypoxic conditions. Methods This study included 263 healthy adults divided into three groups: (1) Native Tibetan group (n=160): aged 18~65 (mean 38.3±13.0) years, residing at≥3 000 meters; (2) Long-term high-altitude Han Chinese group (n=50): aged 18~65 (41.0±7.5) years, residing at≥3 000 meters for≥10 years; (3) Acute High-Altitude Group (n=53): Age 18~36 (23.9±4.4) years, long-term residence in lowland areas (baseline altitude≤50 meters, mean 43.5 meters) with no prior high-altitude exposure. The native and long-term resident groups underwent a single cross-sectional assessment at their high-altitude locations. The Rapid Altitude Group employed a longitudinal study design: baseline measurements were taken at low altitude one week prior to high-altitude exposure (≥3 000 m), with repeated measurements conducted on days 3, 7 and 30 post-exposure. Statistical analysis of complete blood counts compared Hb levels between native Tibetans and long-term Han residents under identical high-altitude steady-state conditions to elucidate the influence of genetic factors on Hb homeostasis regulation. Hb levels were compared between baseline (lowland) and various high-altitude time points to observe acute mountain sickness and early acclimatization processes. Results 1) Hb levels in both male and female indigenous Tibetans were lower than those in long-term high-altitude Han Chinese [Males: (177±24) g/L vs. (203±23) g/L, P<0.01; females: (143±21) g/L vs. (156±24) g/L, P<0.05]; 2) The mean hemoglobin (Hb) level of Tibetan on the plateau in the 18~50-year-old age group was significantly lower than that of Han Chinese who had lived on the plateau for a long time [18~30 years: (157±26) g/L vs. (187±18) g/L, P=0.023; 30~40 years: (153±30) g/L vs. (178±33) g/L, P=0.003; 40~50 years: (156±33) vs. (178±36) g/L, P=0.022). Hemoglobin levels among Tibetan populations permanently residing at high altitudes were concentrated in the ranges of 140~150 g/L (20.63%) and 160~170 g/L (14.38%); among Han populations long-term residing at high altitudes, extremely high hemoglobin values (>200 g/L) accounted for 22%. 3) Hb levels in acutely acclimated populations exhibited a increase with time spent at altitude (7-day mean: 170 vs. baseline 152 g/L, Δ+11.2% increase at 7 days, Δ+4.7% at 30 days, P<0.001). Conclusion Hemoglobin levels serve as a sensitive physiological indicator of high-altitude adaptation across different populations, exhibiting polymorphic distribution patterns among distinct groups.

Objective This study aims to analyze the characteristics of 46 new HLA alleles identified in the Chinese indivivduals and provide insights into selecting HLA-matched donors for hematopoietic stem cell transplantation patients. Methods Based on the sequences of the new alleles obtained by PCR-SBT and group-specific allele amplification sequencing methods, we analyzed the types and positions of nucleotide mutations, amino acid substitutions and their property changes, and constructed three-dimensional structural models of the protein molecules. Results The 46 new HLA alleles include 11 HLA-A, 13 HLA-B, 13 HLA-C, 3 HLA-DRB1 and 6 HLA-DQB1 loci. There are 57 base mutations, of which 53 are point mutations,3 are nucleotide deletions, and 1 is a nucleotide insertion. The amino acid mutations include both synonymous mutations (12) and missense mutations (40), as well as frameshift mutations (4). Of the amino acid substitutions, 22 did not alter the nature of the amino acids, while the remaining 30 resulted in different changes in amino acid properties. Mutations in HLA class Ⅰ molecules mostly occurred in the extracellular regions, including the α1 domain (13), α2 domain (11), and α3 domain (15), with a few in the transmembrane region (4), cytoplasmic region (1), and 1 in the leader sequence. All mutations in HLA class Ⅱ molecules occurred in the extracellular regions, including the β1 domain (9) and β2 domain (2). The three new alleles with deletion mutations resulted in premature termination of protein translation.The nucleotide sequences of the four new alleles with multiple base mutations were searched and aligned in the EMBL-EBI database to analyze whether the mutations might have been generated through gene conversion. Conclusion Our analysis of these new alleles demonstrates the different mechanisms that may contribute to the evolution of HLA polymorphism. These findings will help clinicians identify HLA-matched donors for hematopoietic stem cell transplantation patients and improve the success rate of matching.

Objective To investigate the molecular mechanisms of weak antigen expression by genetic blood typing. Methods We performed serological investigations in voluntary blood donation samples collected between January 2023 and December 2024. Third-generation single-molecule sequencing technology was employed in 7 samples with discrepant results in forward and reverse ABO phenotyping. Results Six cases serologically defined as AB₃ were found to be associated with ABO*A1.02/ABO*B.var (c.28+5885C>T), and one case defined as B_weak with ABO*B.var/ABO*O.01.02 (c.28+5875C>T). Conclusion Sequencing revealed that point mutations occurred in the binding region of the RUNX1 transcriptional regulatory protein in 7 cases, providing a molecular basis for the study of weakened antigen expression.

Objective To investigate the rational application of serological techniques in ensuring safe transfusion for a patient with autoimmune hemolytic anemia (AIHA) following umbilical cord blood transplantation in cases of incompatibility crossmatch. Methods A series of tests, including direct antiglobulin test (DAT), antibody identification test, absorption test, acid elution test, antibody titer measurement, and microcolumn agglutination cross-matching test, were performed on the patient's blood samples. Results The patient's blood type was identified as type B and Lu^a antigen was negativity. A Hemolytic crisis occurred after multiple transfusions of red blood cells. IgG-type anti-Ec and anti-Lu^a antibodies were detected in both serum and exudate samples. Tests showed a delayed hemolytic transfusion reaction (DHTR) caused by anti-Ec. Following compatible red blood cells transfusions, the patient's hemoglobin levels showed a significantly improvement, and flow cytometry results indicated a gradual decrease in the proportion of antigen-sensitized cells in the patient's blood. Conclusion DHTR induced by anti-Ec can exacerbate anemia in AIHA patients and may pose a significant risk of hemolysis. The appropriate selection and application of serological techniques can facilitate the identification of clinically significant antibodies, which is crucial for ensuring the transfusion safety.

Objective To report two cases of hemolytic anemia caused by intravenous immunoglobulin (IVIG) in the newborn. Methods ABO and Rh blood grouping, three tests for hemolytic disease of the newborn, unexpected antibodies identification, and crossmatching were performed by serologic methods. Results Case 1: a neonate with severe HDN caused by anti-C and anti-D. After administration of IVIG, a IgG-A was detected in the neonate's elution fluid. Case 2: a neonate had hyperbilirubinemia due to infection. After administration of IVIG, DAT was weakly positive and IgG-A was detected in the elution fluid. The hemoglobin rose after stopped IVIG and transfused with O-type washed RBCs. Conclusion IVIG may cause hemolytic anemia in newborn. If it happens, the IVIG should be stopped and O-type washed RBCs is feasible for transfusion after compatible crossmatching.

Objective To explore the detection method of low-frequency antigen antibody anti-McCb in a case of hemolytic disease of the fetus and newborn. Methods In this case, the infant developed jaundice 24 hours after birth, which raised suspicion of neonatal hemolytic disease caused by unexpected antibodies other than those of the ABO blood group. The mother's serum showed no reaction with panel cells, so it was necessary to confirm whether the father's red blood cells expressed a certain low-frequency antigen. Therefore, the mother's serum was reacted separately with the father's and the infant's red blood cells. The positive results indicated the presence of antibodies in the mother's serum targeting a certain low-frequency antigen on the father's and the infant's red blood cells. Different enzymes or chemical reagents were used to treat the father's red blood cells, creating different reaction patterns for high-frequency and low-frequency antigens under various enzymes, thereby further identifying the specific antigens and antibodies. Results It is highly suspected that the neonatal hemolytic disease is caused by anti-McCb antibodies. Conclusion PEG enhancement test and enzyme treatment technology are helpful to the detection of anti-low frequency antigen antibodies, and molecular biological methods are still needed for confirmation.

Objective To examine the serological features of a rare case of ABO blood type mosaicism and investigate the appropriate gene sequencing methodologies. Methods Serological tests, Sanger sequencing, and PacBio gene sequencing were used to identify the ABO blood type in a hospitalized patient exhibiting discrepancies in forward and reverse typing. Results Micro-column gel card retesting for forward typing showed double cell populations (DCP) with anti-A reagent and a negative result with anti-B reagent, while reverse typing confirmed type "A". Rh blood group antigens D, C, c, E, and e were not detected as DCP. Using the tube method, the patient's red blood cells (RBCs) showed "2+^w" agglutination with anti-H reagent, whereas no agglutination was observed with anti-A reagent, but a "4+" reaction was seen with anti-H, indicative of a notable difference compared to the gel method. Sanger sequencing yielded inconsistent results acroos the two tests, revealing two different haplotypes: ABO*O.01.01/ABO*O.01.01 and ABO*A1.02/ABO*O.01.01. PacBio sequencing identified a primary haplotype of ABO*O.01.01/ABO*O.01.01 with approximately 400 reads, along with a haplotype of ABO*A1.02, amounting to about 40 reads. Conclusion Serological tests may fail to identity ABO blood type chimerism, and Sanger sequencing and genotyping may not detect mosaicism. However, PacBio third-generation sequencing offers a more accurate method for identifying ABO blood type and quantifying the proportions of haplotypes in chimeric or mosaic blood types.

Nucleated red blood cells (NRBCs) are immature precursors of red blood cells that retain their nuclei during the process of erythropoiesis. Under physiological conditions, NRBCs are predominantly present in the peripheral blood of pregnant women and neonates, while they are rarely detected in healthy adults. However, their levels in peripheral blood increase significantly under various pathological conditions, including hematological disorders, infectious diseases, and malignancies. This elevation is closely associated with adverse clinical outcomes, making NRBCs promising candidates as diagnostic biomarkers and prognostic indicators. This article aims to provide a comprehensive review of recent advances in NRBC research, with a focus on their molecular mechanisms in disease progression, as well as their potential applications in clinical diagnosis, treatment monitoring, and prognosis evaluation, thereby offering a new insight and strategy for precision medicine.

Preoperative anemia occurs in 10% to 30% of adult patients undergoing cardiac surgery, leading to a range of adverse postoperative outcomes. Evidence suggests that implementing targeted management strategies for preoperative anemia can effectively reduce the risk of complications, including postoperative infections, organ dysfunction, and mortality. Current clinical practice presents a diverse array of intervention strategies; however, their efficacy and safety remain to be subjects of ongoing debate. This article systematically reviews the pathophysiological mechanisms underlying preoperative anemia and summarizes the effectiveness and limitations of common interventions such as iron supplementation, erythropoietin administration, and protocols for vitamin B₁₂ and folic acid supplementation, Additionally, it introduces several novel therapeutic approaches for anemia, and provides an overview of comprehensive Patient Blood Management (PBM). Our aim is to offer a reference for personalized clinical management and further research on preoperative anemia.

Anemia is a prevalent complication of pulmonary tuberculosis, exhibiting marked regional and demographic variations in its epidemiological characteristics. Mycobacterium tuberculosis induces anemia in pulmonary tuberculosis patients by impairing host immune function, altering systemic iron metabolism, and exacerbating chronic inflammatory responses. Anemia is intricately linked to the onset and progression of pulmonary tuberculosis and serves as an independent risk factor for disease deterioration and mortality. Clinically, anti-tuberculosis therapy should be integrated with strategies to address anemia. Furthermore, a deeper understanding of the pathogenesis and associated risk factors is warranted to identify effective interventions to provide a theoretical foundation for the precise management of pulmonary tuberculosis patients.

Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) is a condition characterized by the immune-mediated destruction of fetal platelets, which occurs when IgG-specific antibodies from the mother cross the placenta. This process leads to thrombocytopenia in the fetus and/or neonate, giving rise to adverse pregnancy outcomes such as purpura, bruising, intracranial hemorrhage, and even intrauterine fetal death. In Caucasians, the primary antibody responsible for FNAIT is HPA1a antibody, whereas in Asian populations, antibodies such as anti-HPA3a, anti-HPA15, and anti-CD36 may also play a role. Notably, some of these antibodies not only target platelets but also impair placental trophoblast cells, thereby increasing the risk of severe adverse pregnancy outcomes. This review aims to summarize the epidemiology, pathogenesis, clinical features, prevention strategies, and treatment options for FNAIT.