Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Survey of Unexpected Antibodies Identified at a General Hospital in Jeju

제주지역 일개 종합병원에서 동정된 비예기항체의 실태조사

  • Chong, Moosang (Department of Clinical Laboratory Science, Cheju Halla University) ;
  • Lee, Kyu-taeg (Department of Laboratory Medicine, Cheju Halla General Hospital) ;
  • Cho, Young-Kuk (Department of Medical Laboratory Science, Seoyeong University)
  • 정무상 (제주한라대학교 임상병리과) ;
  • 이규택 (제주한라병원 진단검사의학과) ;
  • 조영국 (서영대학교 임상병리과)
  • Received : 2017.11.14
  • Accepted : 2017.11.20
  • Published : 2017.12.31
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Abstract

Unexpected antibody screening and identification tests are highly important in the prevention of hemolytic transfusion reactions. Therefore, it is highly recommended to perform unexpected antibody screening test in all transfusion candidates. Here, the frequency and distribution of unexpected antibodies identified in Jeju for the past 3 years were evaluated. Between Jan 2014 and Dec 2016, unexpected antibody screening test was performed for 10,360 sera of transfusion candidates in Jeju general hospital using a column agglutination method with the Ortho BioVue system (Ortho-clinical Diagnostics, Raritan, NJ, USA). Eighty-seven (0.84%) of 10,360 cases that underwent unexpected antibiotics screening showed positive results. Among them, unexpected antibodies were identified in 41 cases (0.40%). Unidentified antibodies were detected in 8 cases (19.51%) and autoantibodies were detected in 3 cases (7.32%). The anti-E antibody included in warm antibodies were detected most frequently in 8 cases (19.51%); 6 cases (14.63%) of anti-E + anti-c antibody and 3 cases (7.32%) of $anti-Le^a+anti-Le^b$. $Anti-Le^a$ and $anti-Le^b$ antibodies were detected in 2 cases (4.88%), respectively. The anti-D, $anti-Di^a$, $anti-Fy^b$, $anti-Jk^a$, $anti-Jk^b$, anti-M and anti-P1 were detected in 1 case (2.44%). Complex antibodies were detected in 1 case (2.44%) in anti-C+anti-D and anti-E+anti-c+$anti-Jk^b$, respectively. In this study, we analyzed the frequency and distribution of unexpected antibodies in one general hospital for the past 3 years. However, there has been a general increase in multicultural families and foreign workers in Jeju, and it would be a meaningful study to compare the frequency and distribution of unexpected antibodies.

비예기항체(unexpected antibody)는 ABO 혈액형 항체와는 달리 존재 여부를 미리 예측할 수 없는 항체로 주로 임신이나 수혈 등에 의해 다른 적혈구 항원에 노출됨으로써 발생하는 면역항체로서, 비예기항체는 해당 항원을 가진 수혈된 적혈구를 파괴하여 급성 및 지연성 용혈성부작용이나 신생아용혈성질환 등의 수혈부작용을 유발할 수 있다. 2014년 1월부터 2016년 12월까지 3년간 제주특별자치도 종합병원에 비예기항체 선별검사가 의뢰된 10,360명의 혈청 검체를 대상으로 하였으며, 의뢰된 비예기항체 선별결과 양성 결과를 보인 87 검체를 대상으로 조사하였다. 비예기항체가 선별되었던 87건 중 비예기항체 동정검사를 수탁검사기관으로 의뢰한 41 검체(0.40%) 대상으로 분석한 결과 비특이항체가 8건(19.51%), 자가항체가 3건(7.32%)이었다. 이들을 제외하고 항체가 동정된 것은 anti-E가 8건(19.51%), anti-E, anti-c 복합항체가 6건(14.63%), $anti-Le^a$, $anti-Le^b$ 복합항체가 3건(7.32%), $anti-Le^a$와 $anti-Le^b$가 각각 2건(4.88%)으로 조사되었다. 단일항체로는 anti-D, $anti-Di^a$, $anti-Fy^b$, $anti-Jk^a$, $anti-Jk^b$, anti-M, anti-P1이 각각 1건(2.44%)로 나타났으며 복합항체로는 anti-C+anti-D, anti-E+anti-c+$anti-Jk^b$가 각각 1건(2.44%)로 조사되었다. 단일항체가 동정된 검체는 19건(46.34%), 복합항체가 동정된 검체는 11건(26.83%)로 나타났다. 제주지역의 종합병원은 제주시와 서귀포시에 위치한 종합병원 7개 기관이 있으며, 모두 비예기항체 선별검사를 시행하고 있으며, 검사방법으로는 모든 검사실에서 Ortho BioVue system을 이용한 원주응집법으로 검사를 시행하고 있다. 하지만 비예기항체 동정검사는 외부수탁기관에 의뢰하고 있는 실정이다. 이번 연구는 최근 3년간 제주도내 종합병원 1개 기관에서의 동정된 비예기항체 빈도와 분포를 분석하였지만, 점차적으로 제주도내 다문화가정과 외국인 근로자가 증가 추세에 있어 향후 제주지역에 분포한 다수의 종합병원에서 동정되는 비예기항체의 빈도와 분포를 비교 분석한다면 의미가 있는 연구가 될 것이라고 사료된다.

Keywords

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