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

在兽医领域，输血需求急剧增加，以支持需要越来越复杂护理的贫血和出血患者。关于狗和猫的血库和血液相容性的重大知识空白已经填补，但仍有许多有待调查。目前的一个关切是，由于缺乏可靠的血型试剂来源，狗和猫的血型的可持续性受到威胁，并导致大量输血医学知识的流失。我们的血库是兽医输血领域的先驱，在其血液产品和研究/出版物的质量上享有卓越的声誉，这使我们在解决这些问题和追求新型血型研究方面处于独特和优越的地位。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，狗有十几个血型系统，主要被称为狗红细胞抗原（DEA），其中最重要的是DEA 1。第一次输血被认为是安全的，没有事先交叉匹配，因为大多数狗不具有自然产生的抗体。也就是说，在一些未输血的狗中记录了未知临床意义的轻度免疫不相容。由于多次接受输血的人越来越多，新的血型可能会被发现，Dal血型的发现也是如此。dal阴性表型的罕见性暂停了特殊的挑战，因为兼容的血液是稀缺的。除DEA 1外，犬血分型主要依靠多克隆试剂。由于DEA 3、5和Dal分型试剂的可及性有限，为特定患者找到相容的血液可能是艰巨的，进一步的比较血型研究是有限的，甚至可能根本不可能。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异体抗体。2007年，在猫身上发现了一种名为Mik的新型血型。从那时起，尽管已知存在AB和Mik系统外的天然同种抗体，但关于猫血液相容性的研究却很少发表。我们的初步结果表明，15%的猫具有这种同种异体抗体，但其导致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，我们将继续研究狗和猫的血型及其相关同种异体抗体的临床意义。其次，我们的目标是通过生产单克隆分型试剂，为兽医血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制定切实可行的指导方针来提高伴侣动物输血的安全性，并将促进未来血型的抗原和基因型表征。

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.