白血球除去フィルター使用輸血における同種免疫感作の頻度と危険因子  プロスペクティブ研究

  • 安田 広康
    福島県立医科大学医学部附属病院 輸血・移植免疫部
  • 大戸 斉
    福島県立医科大学医学部附属病院 輸血・移植免疫部
  • 色摩 弥生
    福島県立医科大学医学部附属病院 輸血・移植免疫部
  • 山口 脩
    福島県立医科大学医学部附属病院 輸血・移植免疫部
  • 七島 勉
    福島県立医科大学医学部附属病院 第一内科
  • 丸山 幸夫
    福島県立医科大学医学部附属病院 第一内科
  • 菊田 敦
    福島県立医科大学医学部附属病院 小児科
  • 鈴木 仁
    福島県立医科大学医学部附属病院 小児科

書誌事項

タイトル別名
  • Alloimmunization Rate and Its Risk Factors in Recent Trasfusions Using Leukocyte-Reduction Filters. Prospective Study.
  • PROSPECTIVE STUDY
  • プロスペクティブ研究

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抄録

Seventy-eight patients multitransfused using leukocyte-reduction filters at bedside were prospectively studied to determine the rate of post-transfusion alloimmunization and its risk to platelet transfusion. HLA- and HPA-antibodies were detected by standard lymphocytotoxicity test (LCT), antihuman globulin-lymphocytotoxicity test (AHG-LCT) and mixed passive haemagglutination method (MPHA).<br>Of these 78 patients, all of whom had a negative antibody screening on admission, 11 (14%) developed HLA antibodies but only one (1%) developed an HPA antibody. HLA antibodies were detected in 9 (24%) of 38 patients with previous transfusion, pregnancy or both but in only 2 (5%) of 40 patients with no presensitization (p<0.02). Among children (<20 years), one (3%) of 35 patients developed HLA antibodies whereas 10 (23%) of 43 adult patients (≥20 years) developed HLA antibodies (p<0.01). An HPA antibody (anti-HPA-2b) was detected with multireactive HLA antibodies in a woman with previous pregnancy.<br>We conclude that WBC-reduced transfusions decrease primary immunization for HLA and HPA antigens. In presensitized adults, however, these transfusions may provide sufficient antigenic stimulation to boost or sustain a secondary alloimmune response. Women with previous pregnancy were identified as a high-responder group with regard to alloimmunization.

収録刊行物

  • 日本輸血学会雑誌

    日本輸血学会雑誌 46 (1), 7-11, 2000

    一般社団法人 日本輸血・細胞治療学会

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参考文献 (17)*注記

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