Analysis of the cause factor and true frequency of irregular antibodies-associated delated hemolytic transfusion reaction

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K15773
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Laboratory medicine
• Research Institution: Hamamatsu University School of Medicine
• Principal Investigator: Fujihara Harumi 浜松医科大学, 医学部附属病院, 臨床検査技師 (50643350)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 輸血 / 赤血球不規則抗体 / 多施設共同研究 / 前方向性研究

Outline of Final Research Achievements

We planned a multicenter prospective study to examine the seroconversion of irregular antibodies after transfusion. First, we conducted the pilot study. Irregular antibodies were detected in 1.6% (5/307 cases) and 3.8% (10/263 cases) of cases before and after transfusion, respectively. New antibodies were detected in 1.9% (5 cases) of cases after transfusion. The mean amount of erythrocytes transfused (units) to those in whom new antibodies were detected (20 ± 14 units) was significantly greater than that of all other patients (7 ± 8 units) (p ＝ 0.002). No safety or ethical problems were observed in this pilot study.
After that, we started multicenter prospective study with 9 institutions and written informed consent was obtained from 307 cases. Now, we are prospectively investigating causal factor and true frequency of delated hemolytic transfusion reaction.

Free Research Field

輸血・細胞治療

Academic Significance and Societal Importance of the Research Achievements

不規則抗体は、赤血球製剤（RBC）輸血により発現あるいは増加し、輸血をしたRBCと反応して遅発性溶血性輸血副反応（DHTR）の原因となりうる。イギリスでは年間26例の発生、日本ではDHTRが原因の死亡例が報告された。安全な輸血療法を実施していく上で、DHTRの実態を把握することは重要である。しかし現在、輸血後に不規則抗体検査はしないため、DHTRの発生率は不明である。
本研究はDHTRの真の発生頻度と原因因子を解明するため、国内の施設でRBC輸血後に不規則抗体検査を実施し、輸血後に発現する不規則抗体の種類と検出率、発現に影響する因子、不規則抗体発現から消失までの経時的変化を前方的に追跡調査した。