| Project/Area Number |
19K07935
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 52010:General internal medicine-related
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| Research Institution | Hamamatsu University School of Medicine |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
太田 千亜希 (山田) 浜松医科大学, 医学部附属病院, 臨床検査技師 (60770980)
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| Project Period (FY) |
2019-04-01 – 2022-03-31
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| Project Status |
Completed (Fiscal Year 2021)
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| Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2021: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2020: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2019: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
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| Keywords | 不規則抗体 / 遅発性副反応 / 抗原陽性輸血 / 輸血 / 副反応 / 赤血球不規則抗体 / 輸血副反応 / 抗原陽性血 |
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| Outline of Research at the Start |
赤血球不規則抗体陽性例に対して、通常、該当抗原陰性の赤血球製剤を選択し輸血する。しかし、緊急時や夜間帯など、抗原不明のまま、あるいは抗原陽性赤血球（RBC）でも輸血せざるを得ない。抗原陽性RBC輸血を行った場合、アロ免疫による副反応の具体的な頻度と重症度は明確でない。抗原陽性血輸血による副反応に遭遇する機会も相当数あると想定されるが、詳細は不明である。本研究は世界に先駆け、抗原陽性血輸血に焦点をあて、その背景と実態を明確にする。さらに、副反応を最少化するRBCの選択、輸血後副反応への対策に役立てようとする。私たちがこれまで施行してきた後方向性研究結果をもとに前方向性研究を行う。
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| Outline of Final Research Achievements |
In all, 826 cases containing 878 antibodies were registered from 45 institutions. The main reasons for antigen-positive RBC transfusions included‘negative by indirect antiglobulin test' (39%) and ‘detection of warm auto-antibodies’(25%). In 23 cases, some adverse reactions were observed after antigen-positive RBC transfusion, and 25 antibodies (9 of 119 clinically significant and 16 of 646 insignificant antibodies) were detected. Non-specific warm autoantibodies were detected in 9 cases, anti-E in 5 cases, 2 cases each of anti-Lea, anti-Jra or cold alloantibodies, and 1 case each of anti-Dib
, anti-Leb or anti-P1. Other antibodies were detected in 2 further cases. Five (22%) of these 23 cases, who had anti-E (3 cases) or anti-Jra (2 cases), experienced clinically apparent haemolysis. Adverse reactions, especially haemolysis, were more frequently observed in cases with clinically significant antibodies than those with clinically insignificant antibodies (P < 0.001).
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| Academic Significance and Societal Importance of the Research Achievements |
緊急時等で不規則抗体が検出された場合、やむをえず、抗原陽性血が輸血される場合があるが、その原因を明らかにできた。実際に、抗原陽性輸血が施行された場合、副反応が心配されるが、その頻度と、臨床的意義のある抗体、臨床的意義の少ない抗体との関係が明らかになった。
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