Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Investigation of Domestic and Foreign Unexpected Antibodies for Emergency Blood Transfusion

응급수혈을 위한 비예기 항체의 국내·외 실태조사

  • Weonjoo, Hwang (Department of Laboratory Medicine, Pusan National University Hospital) ;
  • Sang-Hee, Lee (Department of Laboratory Medicine, Asan Medical Center) ;
  • Chang-Eun, Park (Department of Biomedical Laboratory Science, Molecular Diagnostics Research Institute, Namseoul University)
  • 황원주 (부산대학교병원 진단검사의학과) ;
  • 이상희 (서울아산병원 진단검사의학과) ;
  • 박창은 (남서울대학교 임상병리학과.분자진단연구소)
  • Received : 2022.11.17
  • Accepted : 2022.12.03
  • Published : 2022.12.31
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Abstract

Certain pre-transfusion tests are not commonly performed during emergency blood transfusion. In this study, we reviewed and analyzed the data of post-blood transfusion antibody screening tests to establish the effects of unexpected antibodies causing hemolytic transfusion reactions. We reviewed information published domestically and internationally, and selected the data of 68,602 antibody screening tests and 528 antibody identification tests conducted at P hospital. We found that unexpected antibody positive (1198,1.74%), Rh type (161, 30.49%), Lewis type (67, 12.69%), others (Di (a), 28, 5.30%). The anti-E type positive was 93 (17.61%), and that of the cases with anti-C (13, 2.46%). Only data of domestic cases were included for analysis that were published before 2007, which established the presence of antibodies of the following types and numbers of cases: anti-E (196, 22.45%), anti-Le a (82, 9.39%), and anti-E+C (60, 6.87%). In 2018, anti-E (107, 17.12%), anti-E+Canti-E+C (56, 8.96%), and anti-Di a (28, 4.48%) were detected. In other domestic cases, S hospital was detect to anti-E, anti-Le a, anti-E+C. The Anti-E, anti-D, anti-E+C, and anti-C+E were detected in D hospital. In Saudi Arabia, Anti-D, anti-E, and anti-Jka was detected. The Anti-M, Anti-N, Anti-Le (a), and Anti-D were detected in India. Requests for emergency blood transfusion increased 1.8 times after the opening of the trauma center. This study has the disadvantage of being a cross-sectional study. additional studies are needed to provide basic information on alternative treatments that can increase the safety and reduce the side effects of hemolytic transfusion in emergency transfusion situations.

환자의 긴급 상황에서 수혈 시 일부 수혈 전 검사를 수행하지 않는다. 수혈 후 항체 선별검사를 실시하여 용혈성 수혈 반응을 일으키는 비예기 항체의 실태를 조사를 비교평가하기 위해 국내·외에 보고된 공시자료를 포함하여 조사하였다. 2014~2016년 P병원에서 항체 선별 검사 68,602건과 항체 동정검사 528건을 선정하였다. 68,602건 중 1,198건(1.74%)이 양성이며 Rh계열 161건(30.49%), Lewis계열 67건(12.69%), 기타(Di (a)등) 28건(5.30%)으로 나타났다. Anti-E는 93건(17.61%), c는 13건(2.46%)이다. 국내·외 공시자료 중 국내 경우는 2007년 이전에는 Anti-E 196건(22.45%), Anti-Le(a) 82건(9.39%) Anti-E+c 60건(6.87%)으로 조사되었지만 2008년 이후에는 Anti-E 107건(17.12%), Anti-E+c 56건(8.96%), Anti-Di (a) 28건(4.48%)으로 조사되었다. 한편 다른 국내의 경우는 S병원(2012~2015년)에는 Anti-E, Anti-Le (a), Anti-E+c이며Anti-E+c이며 D병원(2016~2017년)에는 Anti-E, Anti-D Anti-E+c,Anti-E+c, Anti-C+e로 조사되었다. Saudi의 경우는 Anti-D, Anti-E, Anti-Jk (a)순이며, India 경우는 Anti-M, Anti-N, Anti-Le (a), Anti-D로 조사되었다. 권역별 외상센터 개설 전후시기에 응급수혈요청의 빈도 비교에서는 1.8배 이상이 증가한 것으로 조사되었다. 결론적으로 장기간의 항체분포로 효율성을 검증할 수는 없었지만 수혈의 안전성을 높이고 응급 수혈 상황에서 용혈성 수혈 부작용을 줄일 수 있는 대안을 위해 기초 정보를 제공하고 추가적인 검증연구가 필요할것으로 사료된다.

Keywords

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