Sequential generation of anti-M and anti-Jka leads to two delayed hemolytic transfusion reactions and corresponding strategies
10.13303/j.cjbt.issn.1004-549x.2024.05.003
- VernacularTitle:抗-M、抗-Jka序贯产生致2次迟发性溶血性输血反应及应对策略
- Author:
Honghui LONG
1
,
2
;
Yingying NIU
1
,
2
;
Danting WANG
1
,
2
;
Chunyan HUANG
1
,
2
Author Information
1. Department of Transfusion Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
2. Department of Transfusion Medicine, West China Tianfu Hospital, Sichuan University
- Publication Type:Journal Article
- Keywords:
delayed hemolytic transfusion reaction(DHTR);
anamnestic reaction;
coping strategies
- From:
Chinese Journal of Blood Transfusion
2024;37(5):501-505
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To make transfusion management strategies for patients with history of blood transfusion and/or pregnancy by following up a patient with delayed hemolytic transfusion reactions(DHTR) caused by unexpected antibody produced after blood transfusion. 【Methods】 ABO, Rh, MN and Kidd blood group test, direct antiglobulin test, unexpected antibody screening, antibody identification, antibody titer detection, and cross-matching test were performed on a patient with DHTR. Meanwhile, suitable red blood cells were screened for subsequent treatment. 【Results】 The patient′s blood group was B, RhD(+ ) and CCDee, the antibody screening test and cross-matching test were negative before the first transfusion. After eight days, hemoglobin of the patient decreased to 57 g/L and the laboratory results indicated delayed hemolysis, the antibody screening was positive, and the antibody identification result was anti-M, as RBCs of the patient received typed as M+ N+. After the patient received M antigen negative RBCs, the laboratory test results still indicated delayed serologic transfusion reaction. A new antibody arose and was identified as anti-Jka while RBCs transfused were M-N+ and Jk(a+ b-). Afterwards, it was effective for the patient to receive B, RhD(+ ), M-N+ and Jk(a-b+ ) RBCs. 【Conclusion】 Most of the homologous antibodies produced by patients after blood transfusion will disappear within a few years. When patients undergo another transfusion, DHTR may occur because of anamnestic reaction. Establishing a transfusion management document and creating a card for patients who have already produced RBC alloantibodies can greatly reduce the occurrence of DHTR by informing doctors and staff when the next transfusion is needed.
