Antigen positive blood transfusion for patients having irregular antibodies

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K08933
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Laboratory medicine
• Research Institution: Hamamatsu University School of Medicine
• Principal Investigator: Takeshita Akihiro 浜松医科大学, 医学部附属病院, 准教授 (00242769)
• Co-Investigator(Kenkyū-buntansha): 山田 千亜希 浜松医科大学, 医学部附属病院, 臨床検査技師 (60770980)
• Research Collaborator: Oto Hitoshi ; Watanabe Hiroko ; Ishimaru Ken ; Kawabata Kinuyo ; Nomaguchi Yuriko ; Haraguchi Yasue ; Abe Misao ; Sobue Koki ; Takenouchi Hiroyuki ; Takadate Junko ; Kamimura Masami ; Katai Akiko ; Kasai Daisuke ; Minami Yumiko ; Sugimoto Tatsuya ; Michino Junko ; Nagai Kazuhiro ; Kumagai Mikako ; Hasegawa Yuichi ; Sato Hidehiro ; Takahashi Koki ; Fujii Satoshi ; Otomo Naoki ; Yonemura Yuji ; Yoshida Masaya ; Nagamine Keisuke ; Fujiwara Koki ; Maruyama Mitsuko ; Lee Etsuko ; Yamada Naotomo ; Hashimoto Makoto ; Buseki Yuji ; Hasegawa Mayumi ; Matsuura Hideaki ; Ishikawa Shinsuke ; Tanaka Kazuto ; Osawa Toshiya ; Shinohara Shigeru ; Tatsukawa Yoshiaki ; Sato Genshiro ; Nagamura Tokiko ; Matsunami Misako ; Okamoto Aya ; Oda Nozomi ; Kumano Yumiko ; Asahina Aya ; Nakagiri Itsuro ; Kochi Noriyo
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 赤血球不規則抗体 / 輸血副反応 / 抗原陽性輸血

Outline of Final Research Achievements

We conducted the collaborative study to clarify the detail of antigen (Ag)-positive red blood cells (RBCs) transfusion to the patients conclusively having respective irregular antibodies (Abs). Totally, 826 cases were registered from 45 institutions. The main reasons for Ag-positive RBCs transfusion were ‘negative for indirect anti-globulin test (IAT)’ (35%) and ‘detection of warm auto-Ab’ (29%). Twenty-three cases (3%) observed the adverse reactions of some kind after Ag-positive RBCs transfusion. Anti-E, anti-Lea and anti-Jra Abs were determined in 6, 3 and 2 cases, respectively. Five (22%) of these 23 cases, who have anti-E (3 cases) or anti-Jra (2 cases), experienced clinically apparent hemolysis. Some cases had severe hemolytic adverse reactions after Ag-positive RBCs transfusion in several conceivable situations. We should monitor these transfused cases and start the treatment speedy when necessary.

Free Research Field

血液学、輸血細胞治療学

Academic Significance and Societal Importance of the Research Achievements

不規則抗体陽性患者に当該抗原陽性輸血を行った症例を調査する本研究は世界的にも稀であり、日本発のエビデンスとして、不規則抗体保有患者への輸血の基礎データとなりうる。抗原陽性輸血の調査のシステムを構築することをめざす。本研究終了後も調査は恒常的に継続され、抗原陽性輸血のデータが蓄積されるシステムにする。それにより副反応の頻度や重症度等の数値は、より真の値へ近づき、世界的なガイドラインに引用される可能性が高い。