Cause analysis and measures discussion of immunized blood transfusion refractoriness
Li Hanjun
Zhang Peng
Zhong Xiaolong
Fang Hua
Xiang Xiaohuan
Yang Jingjing
Zeng Feiyan
Luo Hongyu
Abstract：Objective To identify the reasons for immunized blood transfusion refractoriness and discuss strategies to improve transfusion efficiency,and explore whether performing ABO,RhD and other antigen CcEe typing and matching could enhance the effectiveness of blood transfusion.Methods A retrospective analysis was conducted on the clinical data of 43 patients with negative irregular antibody screening who experienced transfusion inefficacy at the Third People's Hospital of Mianyang from 2015 to 2021.The patients were divided into group A(25 cases;transfused after ABO and RhD typing and matching)and group B(18 cases;transfused after ABO,RhD and other antigen CcEe typing and matching).All patients received 2 U of leukocyte-reduced red blood cell suspension.The differences in levels of reticulocyte percentage(Ret%),total bilirubin(TBil)and hemoglobin(Hb)before and after treatment between two groups of patients receiving different blood transfusion methods were compared.Results There were no statistically significant differences in levels of Ret%,TBil and Hb between two groups before treatment.After treatment,the levels of Ret%and TBil in group A were higher than those in group B,and the level of Hb was lower than that in group B,with statistically significant differences[Ret%:(19.59±5.45)%vs.(11.06±3.36)%;TBil(μmol/L):16.42±4.67 vs.10.12±3.26;Hb(g/L):55.92±10.54 vs.64.67±7.22;all P<0.05].The transfusion efficiency in group A was higher than that in group B,with statistically significant difference(38.9%vs.0%,P<0.05).Conclusions When immune blood transfusion is ineffective,identification of other antigens in Rh system and homologous transfusion could significantly improve the transfusion efficiency.Strengthening the construction of information systems for difficult blood combinations while enhancing laboratory testing capabilities in the blood transfusion department could help ensure the safety and effective transfusion of transfusion dependent patients as much as possible.
Keywords：Immunized blood transfusion refractorinessOther antigen of Rh systemEffective blood transfusionInformation system construction
Publication Date：2024-12-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 365-368 )