Disparities in unexpected antibody distribution and clinical features by frequency of cross-matching incompatibility
10.13303/j.cjbt.issn.1004-549x.2025.08.010
- VernacularTitle:不同次数疑难交叉配血患者的意外抗体分布与临床特征差异
- Author:
Danli CUI
1
;
Bujin LIU
1
;
Haiman ZOU
1
;
Pengwei YIN
2
;
Yun QING
1
;
Huayou DAI
1
;
Siqi WU
1
;
Junhong YANG
1
;
Xia HUANG
1
Author Information
1. Institute of Transfusion, Chongqing Blood Center, Chongqing 400052, China
2. College of Public Health, Chongqing Medical University, Chongqing 400016, China
- Publication Type:Journal Article
- Keywords:
cross-matching;
alloantibodies;
autoantibodies;
transfusion safety
- From:
Chinese Journal of Blood Transfusion
2025;38(8):1063-1070
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the clinical characteristics, the types of unexpected antibodies, and their impacts on immunological risks among patients with different frequencies of cross-matching incompatibility, so as to propose corresponding solutions. Methods: Data of cross-matching incompatibility samples from 92 medical institutions during 2022 to 2024 were collected and divided into three groups based on the frequency of cross-matching. Statistical analysis was performed on disease types, distribution of hematologic diseases, alloantibody detection rates, and proportions of alloantibody types. Results: The 858 patients were divided into three groups based on the frequency of blood cross-matching incompatibility: ≥5 times (8.28%, 71/858), 2 to 4 times (28.21%, 242/858); 1 time (63.52%, 545/858). There was a clustered distribution of disease types in the ≥5 cross-matchings group, with 71.83% (51/71) of patients having tumors or hematologic and hematopoietic diseases. In contrast, the disease types in the 2 to 4 cross-matchings and 1 cross-matching groups were more diverse. An analysis of 249 patients with hematologic diseases found that multiple myeloma was the most common disease in all three groups, accounting for 31.43% (11/35), 35.37% (29/82), and 37.88% (50/132) respectively. In the ≥5 cross-matchings group, myelodysplastic syndrome (14.29%, 5/35) and thalassemia (14.29%, 5/35) were the second most common diseases. In contrast, in the 2 to 4 cross-matchings group and 1 cross-matching group, autoimmune hemolytic anemia was the second most common disease, with prevalence rates of 20.73% (17/82) and 24.24% (32/132), respectively. Alloantibodies were detected in 54.66% of the patients, with antibodies against Rh blood group being most frequent (>50%) in all three groups. The detection rates of alloantibodies/alloantibodies with coexisting autoantibodies decreased across groups: the ≥5 cross-matchings group (70.42%, 50/71) > the 2 to 4 cross-matchings group (54.96%, 133/242) > the 1 cross-matching group (52.48%, 286/545). Conclusion: The risk of alloantibody production increases in patients with multiple cross-matching incompatibilities, especially in those with tumors or hematologic diseases. For handling of cross-matching incompatibility cases, it is recommended to optimize the cross-matching process, implement individualized transfusion plans, and enhance the technical capabilities of clinical transfusion departments and blood group reference laboratories to ensure the safety and effectiveness of transfusions.
