Prevalence of HLA antibodies in remotely transfused or alloexposed volunteer blood donors.
Prevalence of HLA antibodies in remotely transfused or alloexposed volunteer blood donors.
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DOI：
10.1111/j.1537-2995.2009.02556.x
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发表时间：
2010-06
期刊：
影响因子：
2.9
通讯作者：
National Heart, Lung, and Blood Institute (NHLBI) Retrovirus Epidemiology Donor Study-II
中科院分区：
文献类型：
--
作者：
Kakaiya RM;Triulzi DJ;Wright DJ;Steele WR;Kleinman SH;Busch MP;Norris PJ;Hillyer CD;Gottschall JL;Rios JA;Carey P;Glynn SA;National Heart, Lung, and Blood Institute (NHLBI) Retrovirus Epidemiology Donor Study-II
对之前输血或怀孕的捐献者进行 HLA 抗体检测可能有助于降低输血相关急性肺损伤 (TRALI) 的风险。然而，输血捐献者中 HLA 抗体的流行情况尚未得到很好的表征。输血和怀孕史是从同意的捐赠者那里获得的。 HLA I 类和 II 类抗体检测通过多抗原珠 Luminex 平台进行。 I 类和 II 类抗体的截止值分别使用标准化背景比 10.8 和 6.9。线性概率模型用于评估 HLA 同种免疫和供者特征之间的潜在关联。 7,920 名捐赠者（2,086 名男性和 5,834 名女性）接受了测试。 895 名输血男性 (1.7%) 和 1138 名未输血男性 (1.0%) 之间 HLA 抗体流行率没有显着差异，[比值比 (OR) 1.75； 95% CI 0.80, 3.82]。 45 名输血未生育女性的患病率（4.4%，95% CI 0.1%，11.8%）与 1732 名非输血未生育女性 1.6% 的患病率（比值比 2.94，95% CI 0.68，12.74）没有统计学差异。输血的经产女性的患病率高于未输血的女性（p=0.004），比值比为 1.39（95% CI 1.07，1.80）。在线性概率模型中，输血诱导同种免疫的估计附加风险仅为 0.8%（95% CI -0.2%，1.8%）（p=0.10）。捐赠者输血历史显示，58% 的输血发生在 10 年以上。接受输血的志愿者献血者的 HLA 抗体患病率似乎并没有明显高于未输血的志愿者。因此，为了降低 TRALI 风险，无需确定既往输血史并测试这些供体的 HLA 抗体。
HLA antibody testing of previously transfused or pregnant donors may help reduce the risk of transfusion-related acute lung injury (TRALI). However, the prevalence of HLA antibodies in transfused donors has not been well characterized. Transfusion and pregnancy history was obtained from consenting donors. HLA Class I & II antibody testing was performed by multi-antigen bead Luminex platform. Cut off values for class I & II antibodies used normalized background ratio of 10.8 and 6.9 respectively. Linear probability models were used to evaluate potential associations between HLA alloimmunization and donor characteristics. 7,920 donors (2,086 males and 5,834 females) were tested. HLA antibody prevalence did not significantly differ between 895 transfused (1.7%) and 1138 non-transfused males (1.0%), [odds ratio (OR) 1.75; 95% CI 0.80, 3.82]. Prevalence in 45 transfused nulliparous females (4.4%, 95% CI 0.1%, 11.8%) was not statistically different from the 1.6% prevalence in 1732 non-transfused nulliparous females (odds ratio 2.94, 95% CI 0.68, 12.74). Transfused parous females had higher prevalence than non-transfused counterparts (p=0.004), odds ratio 1.39 (95% CI 1.07, 1.80). In a linear probability model, the estimated additive risk of transfusion-induced alloimmunization was only 0.8% (95% CI -0.2%, 1.8%), (p=0.10). Donor transfusion history showed that 58% of transfusions occurred >10 years previously. Transfused volunteer blood donors do not appear to have a significantly higher prevalence of HLA antibodies than their non-transfused counterparts. Thus, in an effort to reduce TRALI risk, ascertaining past history of transfusion and testing these donors for HLA antibodies is not necessary.
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影响因子：
2.9
作者：
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通讯作者：
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作者：
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