Application of ZZAP reagent treating allogenic erythrocyte in autoantibodies patients with difficult blood matching
10.3969/j.issn.1671-8348.2024.20.006
- VernacularTitle:ZZAP试剂处理异体细胞在自身抗体患者疑难配血中的应用
- Author:
Bujin LIU
1
;
Danli CUI
;
Haiman ZOU
;
Yun QING
;
Huayou DAI
;
Xia HUANG
Author Information
1. 重庆市血液中心输血研究二所,重庆 400052
- Keywords:
ZZAP reagent;
autoantibody;
alloantibody;
adsorption;
difficult blood cross matching
- From:
Chongqing Medicine
2024;53(20):3072-3076
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the application value of ZZAP reagent in treating allogeneic erythro-cytes for absorption experiment use and in excluding the interference of erythrocyte autoantibodies in pre-transfusion tests.Methods The serological characteristics of 413 cases of erythrocyte autoantibodies interfer-ence in pre-transfusion tests in this center from January 2017 to February 2024 was retrospectively analyzed.The antibody identification adopted different methods.The patients were divided into 3 groups according to the antibody identification method:self-absorption group(the serum after autologous cell absorption test con-ducted the antibody identification and cross matching,n=87),unabsorption group(the serum of the patients conducted the antibody identification and cross-matched,n=277)and allogenic absorption group(the serum after allogeneic erythrocyte absorption test treated by ZZAP reagent condcuted the antibody identification and cross-matched,n=49).Among them,77 cases of allogenic absorption treated by ZZAP reagent and without absorption test were selected and conduct the detailed survey on the blood infusion effective rate and iso-anti-body detection situation.The changes of red blood cell(RBC)count,hemoglobin(Hb)and hematocrit(Hct)were compared before and after blood transfusion.The effect of allogenic cells absorption method for exclu-ding the autoantibodies interference and increasing the blood transfusion effect after ZZAP reagent treating al-logenic cells was analyzed.Results The typing results of antihuman globulin test(direct method)in the pa-tients with RBC atoantibodies were mainly IgG positive and IgG+C3d positive,and the autoantibodies were mainly the warm autoantibodies and cold and warm mixed autoantibodies.HB,RBC Hct after blood transfu-sion in the allogenic absorption group and unabsorption group all were improved.The alloantibody detection rate in the allogenic adsorption group was 42.86%,which was significantly higher than 12.64%in the unab-sorbed group and 11.49%in the autologous adsorption group,and the differences were statistically significant(P<0.001).The total effective rate of blood transfusion in the allogenic adsorption group was 95.92%,which was significantly higher than 78.57%in the unabsorbtion group,and the differences were statistically significant(P=0.016).Conclusion The adsorption of allogeneic cells after ZZAP treatment could serve as a substitute scheme for the inoperable autoadsorption,which effectively excludes the interference of autoanti-bodies on the pre-transfusion test,and increase the safety and effectiveness of blood transfusion.