Analysis of causes of cross-matching secondary side incompatibility and transfusion efficacy
YIN Chuangxin
Tianjin Institute of Endocrinology/Department of Clinical Laboratory, Zhu Xian Yi Memorial Hospital, Tianjin Medical University/Key Laboratory of Hormones and Development, National Health Commission/Tianjin Key Laboratory of Metabolic Diseases, Tianjin 300134, China
Abstract：Objective To analyze the causes and therapeutic effect of cross-matching blood by microcolumn agglutination. Methods The data of 498 patients with cross-matched blood were collected from Zhuxian Yi Memorial Hospital of Tianjin Medical University from January 2021 to October 2023, and the causes of main side compatibility and secondary side inconsistency of cross-matched blood were analyzed. Patients with positive direct antiglobulin test (DAT) were tested for DAT typing and chloroquine diphosphate release test to analyze the positive causes. Results A total of 1115 times of cross-matching were performed in 498 patients, and 446 times (40%) were detected. A total of 433 times (97.1%) were detected as DAT positive in the secondary mismatch, and 416 times (96.1%) were mainly monoclonal IgG types. IgG+C3d mixed type was 15 times, accounting for 3.5%, and simple C3d type was 2 times, accounting for 0.4%. After chloroquine diphosphate release test, the antibody screening test results of red blood cell release fluid of patients were negative. 60 patients with major side compatibility and secondary side incompatibility caused by DAT positive were transfused and transfused suspended red blood cells were selected. After transfusion, the values of hemoglobin (Hb), red blood cells (RBC) and hemocytocyte volume (HCT) were increased and in line with theoretical expectations. Total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) were all within the normal range, with no statistical difference (P>0.05). No hemolytic transfusion reaction occurred, and infusion was effective. Conclusions DAT positive is the main cause of main side compatibility and secondary side incompatibility in patients treated with blood transfusion. Transfusion of suspended red blood cells is safe and effective.
Nathalang O, Sriwanitchrak P, Tubrod J,et al.Antibody elutionsin Thai patients with apositive direct antiglobulin test.BloodTransfus,2011,9(3):306-310.
2024, Vol. 35 
