Research on multi antigen extended matching transfusion in RhCE alloantibody positive patients with blood diseases
10.13303/j.cjbt.issn.1004-549x.2025.05.013
- VernacularTitle:RhCE同种抗体阳性血液病患者的多抗原拓展配型输血研究
- Author:
Pin YI
1
;
Mingming WANG
1
;
Yi ZHU
1
;
Xintang DANG
1
;
Ziyu OU
2
;
Fan WU
3
;
Chaopeng SHAO
1
;
Changlin WU
1
Author Information
1. Department of Transfusion, Shenzhen Second People's Hospital, Shenzhen 518035, China
2. Department of Clinical Medicine, Medical College of Shantou University, Shantou 515041, China
3. Institute of Transfusion Medicine, Shenzhen Blood Center, Shenzhen 518025, China
- Publication Type:Journal Article
- Keywords:
unexpected antibodies;
RhCE;
extended matching;
accurate blood transfusion
- From:
Chinese Journal of Blood Transfusion
2025;38(5):678-683
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To analyze the changes in homologous immunity after RhCE-matched transfusion in positive patients with RhCE blood group antibodies, and to provide precise transfusion strategies for chronic anemia patients. Methods: Patients with chronic anemia in our hospital from January 2020 to March 2024 (continuously receiving blood transfusions for more than 6 months) were enrolled, and 63 cases of unexpected antibody screening positive and identified as RhCE blood group antibodies were selected as the research subjects. The changes in unexpected antibody yield rate after ABO and RhCcDEe isotype blood transfusion were observed. Patients with MNS, Kidd, or Lewis blood group antibodies were screened for corresponding negative donors using monoclonal antibodies for extended typing transfusion based on RhCcEe typing, and the changes in unexpected antibody yield rate after transfusion were observed. Blood group genotyping was performed when serological techniques failed to resolve discrepancies or detect abnormal antigen expression. Results: After RhCcDEe-matched transfusions, RhCE antibodies disappeared in 62 patients, while 1 patient developed anti-Ce. The latter did not develop blood type isotype immunity after receiving RhccEE donor blood. Among the 62 patients, 9 developed unexpected antibodies against other systems: anti-M (4 cases), anti-Mur (2), anti-S (1), anti-Jka (1), and anti-Lea (1). No additional alloimmunization occurred after extended antigen-matched transfusions. A patient with serologically weak e phenotype was genotyped as DCe/DcE, with gene sequencing revealing an 827C>A mutation in exon 6 of the RHCE gene, forming the RHCE
01.31 allele. Conclusion: Precise transfusion strategies incorporating RhCE, MNS, Kidd, and Lewis blood group antigen typing can reduce the probability of blood group homologous immunity. RhCE complex antibodies and RhCE variants pose difficulties for clinical RhCE typing transfusion, which can be addressed through cross-matching and genetic analysis.
