Clinical Investigation in Canine and Feline Transfusion Medicine: Novel Blood Groups and their Clinical Significance

在兽医方面，为了支持需要越来越复杂的护理的贫血和出血患者，对输血的需求急剧增加。关于狗和猫的血库和血液相容性的重大知识空白已经得到填补，但仍有许多有待调查。目前一个令人担忧的问题是，由于缺乏可靠的血型试剂来源，狗和猫的血型鉴定的可持续性受到威胁，以及相关的重要输血医学知识的丧失。我们的血库是兽医输血的先驱，基于其血液产品和研究/出版物的质量而享有非凡的声誉，使我们处于独特和特权的地位，可以解决这些担忧，并从事新血型的研究。我们最近与加拿大动物血库的合作也将促进大规模的临床研究。简而言之，狗有十几种血型系统，大多被称为狗红细胞抗原(DEA)，其中最重要的是DEA 1。首次输血被认为是安全的，除非事先进行交叉配型，因为大多数狗没有自然产生的抗体。这就是说，在一些没有输血经验的狗身上发现了临床意义未知的轻度免疫不相容。由于多个输血接受者更常见，新的血型很可能被识别出来，Dal血型的发现也是如此。DAL阴性表型的罕见暂停了特别的挑战，因为相容的血液很少。除DEA 1外，犬的血型测定依赖于多克隆试剂。由于DEA 3、5和DAL配型试剂的可及性有限，为特定患者找到相容的血液可能很困难，进一步的比较血型研究也是有限的，甚至可能变得根本不可能。相反，猫的AB血型系统的特点是定义明确的自然产生的同种抗体。2007年，在猫身上发现了一种名为Mik的新血型。从那时起，尽管已知存在AB和MiK系统以外的自然产生的同种异体抗体，但关于猫的血液相容性的研究成果很少。我们的初步结果表明，15%的猫具有这种同种抗体，但它们引起输血反应的能力尚不清楚。本文概述的工作将显著提高狗和猫的血液相容性知识。首先，我们将继续调查狗和猫的血型及其相关同种抗体的临床意义。其次，我们的目标是通过生产克隆配型试剂，为兽医血液配型的可持续性提供长期解决方案。资助这项研究将通过为兽医提供切实的指导方针来提高同伴动物的输血安全性，并将促进未来血型的抗原性和基因分型。

In veterinary medicine, the demand for blood transfusions has increase dramatically in order to support anemic and bleeding patients requiring more and more sophisticated care. Significant knowledge gaps concerning blood banking and blood compatibility in dogs and cats have been filled, but much remains to be investigated. A current concern is the threatened sustainability of blood typing for dogs and cats, and the associated loss of significant transfusion medicine knowledge, because of the lack of a reliable source of blood typing reagents. Our blood bank is a pioneer in veterinary blood transfusion with an exceptional reputation based on the quality of its blood products and of its research/publications, putting us in a unique and privileged position to address such concerns and to pursue research of novel blood groups. Our recent collaboration with the Canadian Animal Blood Bank will also facilitate large-scale clinical investigation. Briefly, dogs have a dozen blood group systems mostly known as dog erythrocyte antigens (DEA), with the most important being DEA 1. First-time transfusion is considered safe without prior cross-matching, as most dogs do not possess naturally-occurring antibodies. That said, mild immunologic incompatibilities of unknown clinical significance have been documented in some transfusion-naive dogs. As multiple blood transfusions recipients are more common, novel blood groups are likely to be identified, likewise the discovery of the Dal blood group. The rarity of Dal-negative phenotype pauses particular challenge as compatible blood is scarce. Except for DEA 1, canine blood typing relies on polyclonal reagents. Because of the limited accessibility of DEA 3, 5 and Dal typing reagents, finding compatible blood for a given patient can be arduous, and further comparative blood typing studies are limited and may become simply impossible. In opposite, the AB blood group system in cats is characterized by well-defined naturally-occurring alloantibodies. In 2007, a novel blood group named Mik was identified in cats. Since then, very little has been published on feline blood compatibility despite the fact that naturally-occurring alloantibodies outside of the AB and Mik system are known to exist. Our preliminary results indicate that 15% of cats possessed such alloantibodies, but their capacity to result in transfusion reactions remains unknown. The work outlined herein will significantly improve blood compatibility knowledge in dogs and cats. First, we will continue to investigate the clinical significance of blood groups in dogs and cats and their related alloantibodies. Second, we aim to provide long-term solution to the sustainability of veterinary blood typing by producing monoclonal typing reagent. Funding this research will improve the safety of transfusion for companion animals by generating tangible guidelines for veterinarians and will facilitate future antigenic and genotypic characterization of blood groups.