Effect of blood component transfusion in patients with negative to positive results of direct antiglobulin test after blood transfusion
10.13303/j.cjbt.issn.1004-549x.2021.08.013
- VernacularTitle:输血后直接抗球蛋白试验结果阴性转阳性患者成分血输注效果分析
- Author:
Cheng CHEN
1
;
Qimin YAO
1
;
Xiaoyan HU
1
;
Qi ZHANG
1
;
Rong XIA
1
Author Information
1. Department of Transfusion, Affiliated Huashan Hospital of Fudan University, Shanghai 200040, China
- Publication Type:Journal Article
- Keywords:
direct antiglobulin test(DAT);
negative to positive;
irregular antibody screening;
blood transfusion effect;
blood transfusion volume
- From:
Chinese Journal of Blood Transfusion
2021;34(8):854-857
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To analyze the effect of blood component transfusion when the results of direct antiglobulin test (DAT) changed from negative to positive after blood transfusion. 【Methods】 The data of 215 surgical blood recipients, who were admitted in our hospital from January to October 2019 and presented negative results for both DAT and irregular antibody screening (Anti-screening), were collected via Ruimei Laboratory Management System. DAT and Anti-screening were performed again after blood transfusion, and DAT positive patients(re-test positive group) were then subject to antibody classification and polybrene cross-matching (referred to as cross-matching), and Anti-screening positive patients were tested for irregular antibodies. Patients were stratified by perioperative RBCs transfusion volume as ≤4 U (150 ± 10% mL/U), >4 to 8 U and > 8 U, and DAT-negative patients after blood transfusion were set as the controls, and the transfusion effect of DAT-positive patients after blood transfusion was compared with them. 【Results】 8.84% (19/215) of DAT-negative patients turned positive after RBCs transfusion, among which IgG type accounted for 84.21% (16/19) and IgG+ C3 15.79% ( 3/19); two patients(anti-E and-M, 10.53%) were positive in anti-screening re-test and the rest were negative (89.47%, 17/19). As for cross matching, incompatibility of both primary and secondary side, primary side and secondary side accounted for 5.26% (1/19), 5.26% (1/19) and 10.52 (2/19), respectively, while 78.95% (15/19) showed compatibility of both primary and secondary side. The Hb, RBC and Hct values of the re-test positive group, received RBC transfusion volume (U)≤4 and >4~8, were effectively elevated compared with the controls (P<0.05), while no significant changes of the parameters were noticed when blood transfusion volume >8 U(P>0.05). 【Conclusion】 The conversion of DAT negative results to positive after RBC transfusion indicates the patient has developed antibodies or the incidence of blood transfusion reaction, which can provide references for the clinical choice of appropriate blood components to ensure the safety and effectiveness of blood transfusion.
