대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)

  • 제48권1호
  • /
  • Pages.36-40
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  • 2016
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  • 1738-3544(pISSN)
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  • 2288-1662(eISSN)
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)
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경기일부지역의 적혈구 항체선별검사의 실태조사

Investigation of Red Cell Antiobody Screening Tests Gyeonggi Areas

  • 김대중 (분당제생병원 진단검사의학과) ;
  • 성현호 (동남보건대학교 임상병리과) ;
  • 박창은 (남서울대학교 임상병리학과 분자진단연구소)
  • Kim, Dai-Joong (Department of Laboratory Medicine, Bundang Jesaeng Hospital) ;
  • Sung, Hyun-Ho (Department of Clinical Laboratory Science, Dongnam Health University) ;
  • Park, Chang-Eun (Department of Biomedical Laboratory Science, Molecular Diagnostics Research Institute, Namseoul University)
  • 투고 : 2016.01.18
  • 심사 : 2016.02.03
  • 발행 : 2016.03.31
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초록

적혈구 동종면역은 수혈자와 공여자간의 적혈구 항원의 차이이다. 수혈을 위해서는 혈구형과 혈청형이 일치하지 않으면 적혈구 항체 선별 검사가 필요하며 불일치의 원인을 해명하는 것이 필수적이다. 적혈구 항체 선별검사는 임상적으로 유의한 항체를 검출하고, 신속 정확하며, 신뢰할 수 있는 방법으로 수혈에 앞서 우선적으로 하는 것을 권장한다. 본 연구자들은 다빈도로 검출된 E, D, M, E+c, C+e 항체에 대한 선별검사를 보고하였다. 따라서 이러한 결과로 항-D, 항-E의 항체가 신생아 용혈성 질환, 지연형 용혈성 수혈부작용 반응의 위험요인으로 인식하고자 한다. 또한 혈액안전관리를 적용하기 위해 적합한 항체선별검사가 요구되고, 수혈 위험요인의 선별에 있어 더 나은 효율성을 제공할 것이며 향후에 각 국가에 따라 실질적인 검출빈도를 찾는 연구가 필요할 것으로 사료된다.

Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. The discrepancy of RBC antibody screening test occurs when the results of red cell tests do not agree with those of the serum test. In order to select the proper blood units for transfusion, clarification of the cause of discrepancies is essential. The RBC antibody screening test is an easy, quick, and reliable method for detection of clinically significant antibodies. Antibody screening and identification is recommended prior to transfusion to determine whether there is blood group incompatibility. We reported that phenotyping for E, D, M, E+c, and C+e antibody screening test should be extended. Therefore, these results indicate that anti-D and anti-E alloantibodies were major risk factors for haemolytic disease of the newborn or delayed haemolytic transfusion reactions in this study population. We suggested that its antibody screening be adapted to blood safety interventions. Targeted screening of selected recipients at risk offers less value than universal antibody screening, and more research is needed to determine the real incidence of this national condition.

키워드

참고문헌

  1. Shin JW. Unexpected red cell antibody detection by conditional combination of LISS/Coombs and NaCl/Enzyme gel tests at a tertiary care hospital in Korea: A 5-year study. Blood Res. 2013;48:217-221. https://doi.org/10.5045/br.2013.48.3.217
  2. Lee GH, Gye HI, You SY, Chung CH, Cho MJ, Kim DE. Factors influencing the sensitivity of antibody screening tests with microplate and column agglutination method. Korean J Clin Lab Sci. 1998;30:193-198.
  3. Lee JS, Kim DE, Kim DK. Evaluation of the polyethylene glycol antiglobulin test for routine antibody screening test. Korean J Clin Lab Sci. 1998;30:214-221.
  4. Pathak S, Chandrashekhar M, Whankhede GR. Type and screen policy in the blood bank: is AHG cross-match still required? a study at a multispeciality corporate hospital in India. Asian J Transfus Sci. 2011;5:153-156. https://doi.org/10.4103/0973-6247.83242
  5. Natukunda B, Schonewille H, van de Watering L, Brand A. Prevalence and specificities of red blood cell alloantibodies in transfused Ugandans with different diseases. Vox Sang. 2010;98:167-171. https://doi.org/10.1111/j.1423-0410.2009.01241.x
  6. Enko D, Habres C, Wallner F, Mayr B, Halwachs-Baumann G. Frequencies and specificities of "enzyme-only" detected erythrocyte alloantibodies in patients hospitalized in austria: is an enzyme test required for routine red blood cell antibody screening?. J Blood Transfus. 2014;2014:532919.
  7. Yousuf R, Abdul Aziz S, Yusof N, Leong CF. Incidence of red cell alloantibody among the transfusion recipients of universiti Kebangsaan Malaysia medical centre. Indian J Hematol Blood Transfus. 2013;29:65-70. https://doi.org/10.1007/s12288-012-0155-x
  8. Song DH, Moon IS, Hong SJ, Park JH, Kim JG, Jeon DS. Frequency and distribution of unexpected antibodies of Koreans. Korean J Blood Transfus. 1998;9:191-200.
  9. Broadberry RE, Lin M. The incidence and significance of anti-" Mia" in Taiwan. Transfusion. 1994;34:349-352. https://doi.org/10.1046/j.1537-2995.1994.34494233585.x
  10. Branch DR. Solving the dilemma of prevention of red cell alloimmunization. Immunotherapy. 2012;4:903-905. https://doi.org/10.2217/imt.12.90
  11. Xu P, Li Y, Yu H. Prevalence, specificity and risk of red blood cell alloantibodies among hospitalised Hubei Han Chinese patients. Blood Transfus. 2014;12:56-60.
  12. Winters JL, Pineda AA, Gorden LD, Bryant SC, Melton LJ 3rd, Vamvakas EC, et al. RBC alloantibody specificity and antigen potency in Olmsted County, Minnesota. Transfusion. 2001;41:1413-1420. https://doi.org/10.1046/j.1537-2995.2001.41111413.x
  13. Holuskova I, Lubusky M, Studnickova M, Prochazka M. Erythrocyte alloimmunization in pregnant women, clinical importance and laboratory diagnostics. Ceska Gynekol. 2013;78:89-99.
  14. Sood R, Makroo RN, Riana V, Rosamma NL. Detection of alloimmunization to ensure safer transfusion practice. Asian J Transfus Sci. 2013;7:135-139. https://doi.org/10.4103/0973-6247.115577
  15. Fayek MH, Saad AA, Eissa DG, Tawfik LM, Kamal G. Role of gel test and flow cytometry in diagnosis of Coombs' negative autoimmune haemolytic anaemia. Int J Lab Hematol. 2012;34:311-319. https://doi.org/10.1111/j.1751-553X.2011.01397.x
  16. Jan RH, Yu LC, Wen SH, Tsai SS, Lin TY. Incidence of alloantibodies in transfused patients in Eastern Taiwan. Tzu Chi Med J. 2009;21:66-69. https://doi.org/10.1016/S1016-3190(09)60010-0
  17. Heathcote DJ, Carroll T, Wang JJ, Flower R, Rodionov I, Tuzikov A, et al. Novel antibody screening cells, MUT+Mur kodecytes, created by attaching peptides onto red blood cells. Transfusion. 2010;50:635-641.
  18. Wu KH, Chang JG, Lin M, Shih MC, Lin HC, Lee C, et al. Hydrops foetalis caused by anti-Mur in first pregnancy-a case report. Transfus Med. 2002;12:325-327. https://doi.org/10.1046/j.1365-3148.2002.00394.x

피인용 문헌

  1. 제주지역 일개 종합병원에서 동정된 비예기항체의 실태조사 vol.49, pp.4, 2016, https://doi.org/10.15324/kjcls.2017.49.4.390