DEL RBC transfusion should be avoided in particular blood recipient in East Asia due to allosensitization and ineffectiveness

作     者：Chao-peng SHAO Bao-yan WANG Shi-hui YE Wen-li ZHANG Hua XU Nai-bao ZHUANG Xiao-ying WU Heng-gui XU 

作者机构：Shenzhen Blood Center Shenzhen 518035 China Department of Blood Transfusion the First Affiliated Hospital of Medical College Xi 'an Jiaotong University Xi 'an 710060 China Shaanxi Blood Center Xi 'an 710061 China College of Laboratory Medicine Dalian Medical University Dalian 116044 China 

出 版 物：《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 (浙江大学学报（英文版）B辑（生物医学与生物技术）)

年 卷 期：2012年第13卷第11期

页      面：913-918页

核心收录：

学科分类：1002[医学-临床医学] 1010[医学-医学技术（可授医学、理学学位）] 100215[医学-康复医学与理疗学] 10[医学] 

基　　金：supported by the National Natural Science Foundation of China(No. 30670893) the Foundation of Science and Technology Development Scheme of Shaanxi Province (No. 2010K16-01-12), China 

主　　题：Rh blood group DEL Allo-anti-D Transfusion Pregnancy Delayed hemolytic transfusion reaction 

摘      要：Previously, both primary and secondary anti-D alloimmunizations induced by Asian type DEL (RHD1227A allele) were observed in two incidents. We investigated how often these alloimmunization events occur. The transfusions of any D-negative patients were investigated in the First Affiliated Hospital of Xi an Jiaotong University Medical College, China, during the entire 2009. The antigens of D, C, c, E, and e were routinely serotyped. The Asian type DEL variant was genotyped and the RHD heterozygote was determined through two published methods. The changes in anti-D levels were monitored by the indirect antiglobulin test (IAT) and flow cytometry. Thirty D-negative transfused patients were included in the study. We focused on 11 recipients who were transfused with packed red blood cells (RBCs) from DEL donors at least one time. Of those 11 recipients, seven were anti-D negative before transfusion and four were anti-D positive (one patient with an autoantibody). One of the seven pre-transfusion anti-D negative patients produced a primary-response anti-D after being transfused with 400 ml of DEL blood twice. All four pre-transfusion antibody positive patients were not observed hemoglobin (Hb) levels increased, as expected after transfusions. Two patients had an increase in anti-D from 1:8 to 1:64 by IAT, which was also shown by flow cytometry. None of the patients experienced an acute hemolytic episode. Our data indicated that the primary anti-D induced by DEL transfusion or the secondary anti-D elevated by DEL in a truly D-negative patient might not be unusual. We suggest that a truly D-negative childbearing-aged woman should avoid DEL transfusion to protect her from primary anti-D allosensitization. In addition, anti-D positive recipients should also avoid DEL red cell transfusion due to the delayed hemolytic transfusion reaction (DHTR).