英文摘要 |
Background: Pre-transfusion testing for patients with warm autoantibodies represents a challenge and requires special procedures, including multiple absorptions and complete phenotyping. We advocate a local modified protocol that takes account of blood group antigen distributions of Taiwanese to streamline the pre-transfusion testing cost-effectively without compromising transfusion safety. Study design and methods: Given the blood group distribution frequency of local population, we perform phenotype study of Rh and Kidd antigens and provide Rh- and Kidd phenotype matched units for patients with warm autoantibodies. Thirty adult patients with warm autoantibodies (August 2014 to July 2015) were tested and received transfusions according to this modified policy. Results: Thirteen of 30 patients demonstrated preexisting alloantibodies (43.3%). Twenty-four patients were typed for Rh and Kidd antigens and received prophylactic antigen-matched units. Six patients whose Kidd blood phenotypes could not be determined due to frequent transfusions received Rh antigen-matched units. These 30 patients totally received 702 units of donor red cells (range 2-116 units/ patient, mean 23.4 units/ patient) during the study period (In Taiwan, one unit of red cells is derived from 250 mL whole blood, equal half western standard unit). All patients had expected post-transfusion increments in hemoglobin and hematocrit levels. Conclusion: We instituted a protocol for local patients with warm autoantibodies with limited phenotype- matched transfusion. Our algorithm simplified the pretransfusion work-up while maintain adequate transfusion safety for local patients. |