RhD阴性患者输注“亚洲型”DEL型红细胞短期内引起高效价抗-D的同种免疫研究  

High-titer Anti-D alloimmunization shortly after transfusion of“Asia type”DEL red blood cells in an RhD negative patient

作　　者：卢霞 潘英芳 赵爱平[1] 徐群[1] 沈云青[1] LU Xia;PAN Yingfang;ZHAO Aiping(Shandong Blood Center,Jinan 250000)

机构地区：[1]山东省血液中心,山东济南250000

出　　处：《临床输血与检验》2023年第6期835-839,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的通过对1例RhD阴性患者输注“亚洲型”DEL红细胞后诱发同种抗-D免疫的研究分析,探讨RhD阴性患者输注DEL型策略。方法采用血清学方法进行ABO及Rh系统血型抗原检测、不规则抗体筛查及鉴定,高分辨熔解曲线和基因测序分析检测DEL型的RHD基因分型。结果受血者为O型,RhD阴性。供血者为RHD 1227G>A突变的“亚洲型”DEL,Rh表型为Ccee。受血者输血后抗体筛查阳性,并鉴定为抗D和抗C,抗D效价512,抗C效价128。结论RhD阴性患者输注“亚洲型”DEL红细胞会引起抗-D同种免疫。因此对于RhD阴性献血者应加强DEL型的筛查,必要时可以增加RHD基因检测以保障输血安全。Objective We analyzed the anti-D alloimmunization induced by transfusion of"Asia type"DEL red blood cells(RBCs)in an RhD negative individual to develop a strategy of such transfusion.Methods ABO and Rh system blood group antigens were examined,and irregular antibodies were screened and identified by the serological method.RHD genotyping of DEL type was detected by high-resolution melting(HRM)and gene sequencing analyses.Results The recipient was found to be type O and RhD negative.The donors had“Asia type”DEL with the RHD1227G>A mutation and the Rh phenotype was Ccee.The routine pre-transfusion alloantibody screening test was positive after the last blood transfusion.Anti-D(titer,512-fold)and Anti-C(titer,128-fold)were identified by further alloantibody identification.Conclusion Transfusion of"Asia type"DEL RBCs in RhD-negative patients could induce anti-D alloimmunization,therefore making it crucial to enhance DEL type screening for RhD-negative blood donors,and,if necessary,add RHD gene testing to guarantee transfusion safety.

关 键 词：RH血型 “亚洲型”DEL型 抗-D 同种免疫 RHD 1227G>A 突变 

分 类 号：R457[医药卫生—治疗学]