Investigation on prevention of transfusion reactions and establishment of a hemovigilance system
SONG Xuezhen;SONG Xuemei;REN Xiaoning;WANG Yili;XIN Xiaowen;WANG Mingjing;WANG Guoli;Weihai Municipal Hospital of Dalian Medical University;Weihai Blood Center;
Objective To investigate on the strategies to prevent transfusion reactions,to establish a hemovigilance system of clinical transfusion in Weihai and to promote safe and effective clinical transfusion therapy. Methods Microcolumn gel method,polybrene and solid agglutination were used for screening in 7 227 cases of patients in order to test autoimmune antibody before transfusion. Among these cases,33 cases of patients with complete remission after chemotherapy were divided into a study group( 18 cases) and a control group( 15 cases). Autologous platelets were collected from the patients of the study group who received an intermittent chemotherapy. Their platelets were added 5% DMSO and were stored at- 80℃.When platelet count dropped below 10 ×10~9/ L or when symptoms of bleeding occurred,patients were transfused with the autologous platelets. While in the control group,they were transfused with allogeneic fresh platelets. The quality of autologous cryopreserved platelets were analyzed through platelet count,corrected count increment( CCI) and Thrombelastography( TEG) coagulation. Results We detected 37 cases of autoimmune antibodies in 7 227 cases of patient samples,including23 cases of RBC blood group antibodies and 14 cases of platelet antibodies,at a positive rate of 0. 51%. Among the 37 cases,14 were males,23 were females. The positive rate of female patients was significantly higher than men( P 0. 05). 23 cases of RBC blood group antibodies were mainly Rh system based,accounting for 43. 48%,followed by MN system,accounting for 17. 39%. The clinical distribution of autoimmune antibodies in the blood of cancer patients were patients who have received repeated blood transfusions in the past,accounting for 78. 38%. In 16 cases of hematological patients,autologous platelets were collected 24 times,whose count were 154. 18 ×10~11 and packed into 66 therapeutic doses of cryopreserved platelets. The number of autologous cryopreserved platelets were( 2. 36 ± 0. 23) ×10~11and( 1. 94 ± 0. 17) ×10~11 before and after thawing( P 0. 01). The platelet aggregation studies were( 70. 38 ± 4. 98) mm and( 77 ± 5. 41) mm( P 0. 01),respectively. There was no significant difference in the 24 h CCI and the total effective rates among the 53 cases of autologous cryopreserved platelets and 55 cases of allogeneic fresh platelets. The 24 h CCI of the two group were( 11. 25 ± 6. 45) ×10~9/ L and( 10. 49 ± 5. 72) ×10~9/ L. The total effective rate were 81. 13% and 83. 63%,respectively( P 0. 05). Conclusion The detection of autoimmune antibodies and autotransfusion technology can improve the efficacy of blood transfusion and prevent possible transfusion reactions. The establishment of a hemovigilance system of clinical transfusion will guarantee the safety and efficacy of clinical transfusion.
【CateGory Index】： R457.13
【CateGory Index】： R457.13