Abstract
Introduction. In patients after multiple blood transfusions, the serological determination of ABO and Rhesus blood groups becomes unreliable due to posttransfusion chimerism, i.e., circulation in the blood of two erythrocytes populations – own and donors. To solve this problem helps the genotyping of blood groups. The literature review includes 42 literature sources, including 9 Russian and 33 foreign articles. Materials and methods . The authors typed blood samples of 24 patients with hematological disorders after numerous erythrocyte-containing transfusions. Antigens A and B, Rh D, Rh C/c, Rh E/e were determined by the serological method using monoclonal antibodies anti-A, antiB, anti-D, anti-C, anti-Cw , anti-c, E and anti-e (Moabs) (Hematologist, Russia). The presence of chimerism was established by hemagglutination typing in gel columns ID-Cards «DiaClon ABO / D + Reverse Grouping» and «DiaClon Rh-subgroups + K». The DNA extract was examined by PCR-SSP using commercial primers ABO-TYPE and RH-TYPE (BAG, Germany). Results . In two patients with 50% chimerism with anti-A and anti-B monoclones, the ABO blood group was genotypically identified. Using molecular method presence of Rhesus system antigens was established in 24 patients with 20-95% chimerism for 1-5 antigens. Serological determination of blood groups at 4 months after the cessation of blood transfusions has confirmed all genotyping results. Conclusion . Genotyping is advisable to use to determine the blood groups in patients after numerous erythrocyte-containing transfusions, which allows increasing immunological safety and preventing alloimmunization to clinically significant erythrocytes antigens.
Highlights
In patients after multiple blood transfusions, the serological determination of ABO and Rhesus blood groups becomes unreliable due to posttransfusion chimerism, i.e., circulation in the blood of two erythrocytes populations – own and donors. To solve this problem helps the genotyping of blood groups
Antigens A and B, Rh D, Rh C/c, Rh E/e were determined by the serological method using monoclonal antibodies anti-A, antiB, anti-D, anti-C, anti-Cw, anti-c, E and anti-e (Moabs) (Hematologist, Russia)
The presence of chimerism was established by hemagglutination typing in gel columns ID-Cards «DiaClon ABO / D + Reverse Grouping» and «DiaClon Rh-subgroups + K»
Summary
In patients after multiple blood transfusions, the serological determination of ABO and Rhesus blood groups becomes unreliable due to posttransfusion chimerism, i.e., circulation in the blood of two erythrocytes populations – own and donors. Было показано, что ПЦР позволяет быстро и надежно определять аутологичные группы крови систем ABO, резус, Келл, Кидд и Даффи, даже если больной недавно перенес множественные трансфузии. [35] с учетом того, что результаты серологических исследований групповых факторов разных антигенных систем эритроцитов могут оказаться ошибочными из-за предшествующих многократных трансфузий вследствие появления кровяных химер, провели сравнительный анализ данных фенотипирования и генотипирования групп крови у ряда больных с заболеваниями, требующими постоянных трансфузий (талассемия и др.). [39] утверждают, что, хотя молекулярное генотипирование действительно становится все более дешевым и широко применяемым, но при существующей ограниченности ресурсов даже эффективные и широко распространенные тестовые методы вряд ли смогут решить базовую проблему нехватки совместимой крови, поэтому анализ ДНК необязательно применять во всех случаях, чтобы не удорожать исследование.
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