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目的:观察ABO血型不合的患者异基因造血干细胞移植前后血型抗原转变及抗体效价的变化,为患者输注血液成分的选择提供依据。方法:在干细胞移植前对患者和供者进行HLA配型、ABO及RhD血型鉴定,移植后定期检测患者ABO血型抗原强度及抗体效价的变化,对输注血液成分的种类进行统计分析。结果:22例ABO血型不合的患者干细胞移植后28～45 d血型抗原转变为供者血型,56～80 d血清中可检出凝集素,抗体效价为1∶4～1∶8,但部分患者的血清中未检出相应的凝集素,正反定型结果不相符。结论:ABO血型不合的干细胞移植后,患者血型抗原转变为供者血型,输血时应选择不被患者血清中抗体所凝集的不含相应抗原的红细胞,以及供者血清中不含相应抗体的血小板或血浆进行输注,确保输血安全。
OBJECTIVE: To observe the changes of blood group antigens and antibody titer before and after allogeneic hematopoietic stem cell transplantation in patients with ABO incompatible blood types, and provide basis for the choice of blood components in patients with ABO. Methods: HLA matching, ABO and RhD blood group identification were performed on patients and donors before stem cell transplantation. The changes of ABO blood group antigen intensity and antibody titer were detected regularly after transplantation. The types of blood components were analyzed statistically. Results: Twenty-two patients with ABO incompatibility changed from blood type antigen to donor blood type at 28-45 days after stem cell transplantation. Lectins were detectable in serum from 56 to 80 days after antibody transfection. The antibody titers ranged from 1: 4 to 1: 8, but some Patients did not detect the corresponding serum lectin, positive and negative stereotypes do not match. CONCLUSIONS: After ABO-incompatible stem cell transplantation, the blood group antigen of patients transforms into blood type of donor. Blood transfusion should choose erythrocytes that do not contain the corresponding antigen agglutinated by the antibody in the patient’s serum and platelets that do not contain the corresponding antibody in the donor serum Or plasma infusion to ensure blood transfusion safety.