CD47单抗对输血前检测的影响及处理措施  

Effect of CD47 monoclonal antibody on pre-transfusion detection and treatment measures

作　　者：陈涛[1,2] 许丹 倪修文 CHEN Tao;XU Dan;NI Xiuwen(Zhejiang Chinese Medical University,Hangzhou,310053,China;Department of Blood Transfusion,the First Hospital of Jiaxing;Department of Laboratory,Jiaxing Blood Center)

机构地区：[1]浙江中医药大学,杭州310053 [2]嘉兴市第一医院输血科 [3]嘉兴市中心血站检验科

出　　处：《临床血液学杂志》2024年第10期742-745,共4页Journal of Clinical Hematology

摘　　要：目的:分析探讨CD47单抗对输血相容性检测的干扰和处理。方法:血型鉴定采用盐水法和微柱凝胶法;盐水法、间接抗人球蛋白法(IAT法)、凝聚胺法、酸放散处理法进行抗体筛选和鉴定;分别用木瓜蛋白酶、二硫苏糖醇(DTT)处理抗筛细胞,观察能否消除抗CD47抗体的干扰;用O型献血者红细胞与患者血浆进行吸收试验。结果:CD47单抗干扰ABO血型反定型,且患者抗体筛选和鉴定试验在所有介质中均出现凝集,患者红细胞酸放散液与谱细胞反应均为阳性。酶及DTT不能消除CD47单抗对抗筛试验的影响。异体红细胞吸收4次患者体内抗体效价为2 187。结论:抗CD47抗体会干扰输血前检测,建议治疗前检测患者的血型并进行抗体筛选等,输注同型匹配性血液,以保障安全输血。Objective: To analyze and explore the interference and treatment of CD47 monoclonal antibody on the detection of transfusion compatibility. Methods: The blood type of the patients was identified by saline method and microcolumn gel method. The antibody was screened and identified by saline method, IAT method, coagulated amine method and acid release method. Anti-screening cells were treated with papain or DTT to observe whether the interference of anti-CD47 antibody could be eliminated. Absorption test was performed with red blood cells of type O blood donors and patient plasma. Results: CD47 monoclonal antibody interfered with ABO reverse typing, and patient's antibody screening and identification tests showed agglutination in all media. The erythrocyte acid dispersive fluid of the patient reacted positively with the spectrum cells. Enzyme and DTT could not eliminate the effect of CD47 monoclonal antibody on anti-screening test. The antibody titer in the patients with allogeneic red blood cell absorption for 4 times was 2 187. Conclusion: Anti-CD47 antibodies can interfere with pre-transfusion testing. It is recommended to test the patient's blood type and perform antibody screening before treatment, and transfuse homozygous matching blood to ensure safe blood transfusion.

关 键 词：CD47单抗 不规则抗体筛选 输血相容性检测 

分 类 号：R457.1[医药卫生—治疗学]