Effects of ABO blood group factors on erythrocyte suspension transfusion reactions

Abstract

Objective To investigate the effects of ABO blood group factors on erythrocyte suspension(RCS)transfusion reactions in patients. Methods Test Ⅰ A total of 12 600 patients in whom RCS was transfused during operation at the department of anesthesiology of 11 hospitals of Inner Mongolia from January 2006 to January 2014 were selected.The occurrence of transfusion reactions(fever [an increase in body temperature>1 ℃ than that before transfusion], allergy, hemolysis)was recorded in the patients.Test Ⅱ A total of 120 RCS-transfused patients of both sexes, aged 18-55 yr, weighing 45-75 kg, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, who underwent surgical operation, were divided into 4 groups(n=30 each)according to the blood group: blood group A group(group A), blood group B group(group B), blood group O group(group O)and blood group AB group(group AB). The standard for RCS transfusion was defined as hemoglobin(Hb) 10 g/L.Before induction of anesthesia(T1), before blood transfusion(T2), and at 5 min, and 1, 6 and 24 h after blood transfusion(T3-6), blood samples were collected from the central vein for determination of the plasma tumor necrosis factor-alpha(TNF-α), interleukin-4(IL-4)and IL-10 concentrations by enzyme-linked immunosorbent assay. Results Among the 12 600 RCS-transfused patients, 216 cases developed transfusion reactions, and the incidence of transfusion reactions was 1.714%.For the patients of different blood groups, the incidence of transfusion reactions from the high to the low was blood group B, blood group AB, blood group A, and blood group O in turn(P<0.05 or 0.01). Compared with group B, the plasma TNF-α and IL-10 concentrations were significantly decreased, and the plasma IL-4 concentrations were increased at T3-T6 in the other three groups(P<0.05). Compared with group AB, the plasma TNF-α and IL-10 concentrations were significantly decreased, and the plasma IL-4 concentrations were increased at T3-T6 in A and O groups(P<0.05). Compared with group O, the plasma TNF-α and IL-10 concentrations were significantly decreased, and the plasma IL-4 concentrations were increased at T3-T6 in group A(P<0.05). Conclusion ABO blood group factors affect RCS transfusion reactions in the patients, and the incidence of transfusion reactions from the high to the low is blood group B, blood group AB, blood group A, and blood group O in turn. Key words: ABO blood-group system; Blood component transfusion