Transfusion strategy to ABO-incompatible grafts in allogeneic hematopoietic stem cell transplantation

doi:10.3969/j.issn.2095-4344.2015.06.016

Abstract

Abstract:

BACKGROUND: Hematopoietic stem cell transplantation is an important means for clinical cure of hematologic malignancies, congenital hereditary diseases and autoimmune diseases. Although ABO-incompatibility has no effects on the survival of transplanted hematopoietic stem cells, the transfusion strategy to ABO-incompatible grafts in allogeneic hematopoietic stem cell transplantation is worth studying.
OBJECTIVE: To explore the antigen-antibody changes during blood conversion after ABO-incompatible hematopoietic stem cell transplantation as well as transfusion strategies.
METHODS: Blood grouping, antibody detection, antibody titer determination, cross-match test were employed for antigen-antibody monitoring during blood conversion and pre-transfusion compatibility detection in 24 cases undergoing ABO-incompatible allogeneic hematopoietic stem cell transplantation. Another 30 cases undergoing ABO-compatible allogeneic hematopoietic stem cell transplantation were enrolled as controls to select the appropriate blood.
RESULTS AND CONCLUSION: All of the 24 ABO-incompatible patients developed the hematopoietic reconstitution after transplantation, but both major and major-minor ABO incompatibility were different from ABO compatibility in the time of erythrocytic recovery (P < 0.05). According to the changes of ABO antigen and antibody during the blood conversion, the patients of major ABO incompatibility were selected the red blood cells of their own type, the patients of minor ABO incompatibility were selected the red blood cells of the blood group from patients to donors gradually, and the patients of major-minor ABO incompatibility were selected the red blood cells from O-type blood to donor’s type gradually. None of the 24 recipients presented hemolytic reaction during transplantation and after transfusion. Therefore, the transfusion strategy to ABO-incompatible grafts in allogeneic hematopoietic stem cell transplantation is dynamically varied according to the changes of patient’s ABO antigen and antibody, and evaluating the recovery of erythropoietic system can guide blood component selection, avoid hemolytic transfusion reaction, and insure the safety of hematopoietic stem cell transplantation.

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

全文链接：

Key words: Hematopoietic Stem Cell Transplantation, Blood Group Incompatibility, Blood Transfusion

CLC Number:

R394.2

Xu Jin-hua, Li Xiao-feng. Transfusion strategy to ABO-incompatible grafts in allogeneic hematopoietic stem cell transplantation[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(6): 913-917.

Figures/Tables 2

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