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Mollison’s Blood Transfusion in Clinical Medicine - part 2

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tần số tương đối của các kháng thể tế bào miễn dịch màu đỏ * (không bao gồm anti-D, đĩa CD-và-DE): (a) và (b) người được truyền (và một số phụ nữ mang thai), (c) liên quan với các phản ứng truyền máu ngay lập tức tan máu và (d) liên kết với các phản ứng truyền máu tán huyết chậm. | CHAPTER 3 Table 3.6 Relative frequency of immune red cell antibodies excluding anti-D -CD and -DE a and b in transfusion recipients and some pregnant women c associated with immediate haemolytic transfusion reactions and d associated with delayed haemolytic transfusion reactions. No. of cases Blood group systems within which the various alloantibodies occurred Rh excluding -D f K Fy Jk Others a 4523 51.8 28.6 10.2 4.2 5.2 b 705 61.4 24.7 10.2 2.4 1.3 c 142 42.2 30.3 18.3 8.5 0.7 d 82 34.2 14.6 15.9 32.9 2.4 a Grove-Rasmussen 1964 b Tovey 1974 c Grove-Rasmussen and Huggins 1973 d data from the Mayo Clinic and Toronto General Hospital for further details see Chapter 11. That is excluding antibodies of the ABO Lewis and P systems and anti-M and anti-N. f Almost all anti-E or -c. antibodies other than anti-D 0.22 anti-K 0.19 anti-Fya 0.05 and anti-Jka 0.035 . Patients with thalassaemia are usually transfused about once per month starting in the first few years of life. In some series in which patients have been transfused with blood selected only for ABO and D compatibility antibodies mainly of Rh or K specificities have been found in more than 20 of patients. For example out of 973 thalassaemics transfused with an average of 18 units per year from about the age of 3 years 21.1 had formed clinically significant antibodies after about 6 years 84 of the antibodies were within the Rh or K systems about half the immunized patients made antibodies of more than one specificity. Of 162 patients transfused from the outset with red cells matched for Rh and K antigens only 3.7 formed alloantibodies compared with 15.7 of 83 patients of similar age transfused with blood matched only for D Spanos et al. 1990 . The incidence of antibody formation is less when transfusion is started in the first year of life Economidou et al. 1971 . The induction of immunological tolerance by starting repeated transfusions at this time was believed to account for the low rate of alloimmunization .