How to eliminate the interference of warm autoantibodies with antibody identification
10.13303/j.cjbt.issn.1004-549x.2021.08.002
- VernacularTitle:温自身抗体干扰抗体鉴定的应对策略
- Author:
Kaiqi KUANG
1
;
Siyuan LIU
2
;
Ningjie ZHANG
2
;
Yanhong BU
2
;
Rong GUI
3
;
Yonghe YAN
1
Author Information
1. Changsha Blood Center, Changsha 410001, China
2. The Second Xiangya Hospital, Central South University
3. The Third Xiangya Hospital, Central South University
- Publication Type:Journal Article
- Keywords:
warm autoantibody;
red blood cell blood group;
antibody identification;
alloantibody;
specific autoantibody;
autoimmune hemolytic anemia
- From:
Chinese Journal of Blood Transfusion
2021;34(8):809-812
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To investigate the effect of serological methods for eliminating the interference of warm autoantibodies with the compatibility test before blood transfusion. 【Methods】 The blood samples (whole blood and serum, 3 mL/each) of 10 cases of warm autoantibodies interfering with antibody screening and identification were collected. Autogenous or allogeneic red blood cells(RBCs) were treated with microthermal(45 ℃), chloroquine, or ZZAP (dithiothreitol and papain) reagents, and then were used to absorb the autoantibodies in patients′ plasma. The plasma after absorption and RBC elution were used for antibody identification by anti-human globulin method or Polybrene method to determine the specificity of the autoantibody/alloantibody. Blood transfusion with ABO/Rh homotypic RBCs without corresponding antigens was performed in patients with alloantibodies or specific autoantibodies, and the efficacy of blood transfusion was evaluated. 【Results】 The interferenc of warm autoantibodies with antibody screening and identification due to primary or secondary autoimmune diseases were eliminated after absorption, and IgG isospecific antibodies (anti-E, anti-Jka, anti-Wra) in 3 cases and specific autoantibodies (anti-Ce) in 1 case were yielded. 6 of the 10 patients received blood transfusion, and 4 with specific antibodies avoided exposure to corresponding antigens. After transfusion of 2U suspended RBCs, the increase of hemoglobin at 24h in all 6 patients was greater than 10 g/L, and no hemolytic transfusion reaction occurred. Anemia symptoms were improved after transfusion. 【Conclusion】 Appropriate elution methods and autologous/allogeneic absorption methods can eliminate the interference of warm autoantibodies with the identification of alloantibodies, therefore can accurately identify the types and properties of antibodies, thus providing targeted and effective blood transfusion.
