The differentiation of delayed hemolytic and delayed serologic transfusion reactions: incidence and predictors of hemolysis
The differentiation of delayed hemolytic and delayed serologic transfusion reactions: incidence and predictors of hemolysis
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迟发性溶血和迟发性血清学输血反应的区别：溶血的发生率和预测因素
DOI：
10.1046/j.1537-2995.1995.35195090655.x
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发表时间：
1995
期刊：
影响因子：
2.9
通讯作者：
S. Moore
中科院分区：
文献类型：
--
作者：
E. Vamvakas;A. Pineda;R. Reisner;P. Santrach;S. Moore
背景技术背景：在区分了临床可检测的迟发性溶血反应（DHTR）和迟发性血清学输血反应（DSTR）后，先前的研究者通过对具有DHTR或DSTR血清学证据的患者进行回顾性分析，计算出DHTR：DSTR的发病率比为18：72。没有发表的数据，可能会影响DHTR与DSTR的发生在一个给定的患者的因素。研究设计和方法：对1980年至1992年期间在马约诊所接受DHTR或DSTR临床诊断并同时接受血清学诊断的292例患者进行回顾性分析。红细胞同种抗体特异性，患者的网状内皮系统的活动，并同时免疫抑制进行了评估，作为潜在的预测DHTR与DSTR的发生在不同的患者。结果：DHTR或DSTR的发生率为1/1899输注的同种异体红细胞单位，DHTR：DSTR的比例为36：64。同种抗体特异性是在临床水平上影响DHTR与DSTR发生的唯一变量，抗Jka和抗Fya特异性以及多种共存特异性与可检测到的溶血显著相关（p < 0.05）。结论：当同时进行临床和血清学诊断并进行适当的溶血检查时，发现临床可检测的DHTR比以前认为的更常见。某些同种抗体特异性与可检测到的DHTR的相关性可能对临床输血实践产生影响。
BACKGROUND: After differentiation of the entities of clinically detectable delayed hemolytic (DHTR) and delayed serologic transfusion reactions (DSTR), previous investigators calculated a DHTR:DSTR incidence ratio of 18:72 from a retrospective review of patients with serologic evidence of DHTR or DSTR. There are no published data on factors that may influence the occurrence of DHTR versus DSTR in a given patient. STUDY DESIGN AND METHODS: Retrospective review was conducted of 292 patients at the Mayo Clinic who, between 1980 and 1992, received a clinical diagnosis of DHTR or DSTR concurrently with a serologic diagnosis. Red cell alloantibody specificity, the activity of the patient's reticuloendothelial system, and concurrent immunosuppression were evaluated as potential predictors of the occurrence of DHTR versus DSTR in different patients. RESULTS: The incidence of DHTR or DSTR was 1 in 1899 allogeneic red cell units transfused, with a DHTR:DSTR ratio of 36:64. Alloantibody specificity was the only variable that affected the occurrence of DHTR versus DSTR at the clinical level, with the anti‐Jka and anti‐Fya specificities, as well as multiple coexisting specificities, significantly associated with detectable hemolysis (p < 0.05). CONCLUSION: Clinically detectable DHTRs are found to occur more commonly than previously believed when the clinical and serologic diagnoses are made concurrently and appropriate work‐ups for hemolysis are ordered. The association of certain alloantibody specificities with detectable DHTRs may have implications for clinical transfusion practice.
影响因子：
4.5
作者：
BLUMBERG N;TRIULZI D J;HEAL J M
通讯作者：
HEAL J M