DISTRIBUTION OF ERYTHROCYTE ANTIGENS AND ALLOIMMUNIZATION INDEX OF CARDIAC SURGERY PATIENTS IN THE SOUTH FEDERAL DISTRICT AND THE NORTHERN CAUCASUS FEDERAL DISTRICT

Introduction. Massive transfusions of allogenic erythrocytes boost risk of post-transfusion reactions and complications for recipients, among them most severe are the immune hemolytic complications. Ensuring the safety of blood transfusion maintenance of high-tech operations on the heart and blood vessels is an important task.

Objective: An analysis of the distribution of erythrocyte antigens of AB0 and RH systems among patients and the incidence of anti-erythrocyte antibodies. Materials and methods. 13,948 patients’ blood samples were examined in 2014— 2016. In the first half of 2017, antibodies (secondary screening) were further examined on days 5—7 and 12—14 after blood transfusion of 51 patients with massive transfusions and/or transfusions of donor RBC containing at least one antigen not found in the recipient’s (C, c, E, e). Immunological studies and selection of a donor-recipient pairs were performed by highly sensitive methods in gel cards of the diagnostic system Diagnostic Grifols SA (Spain).

Results. The study showed that the use of the gel technique in antibodies screening increases their detectability by several times (from 0.15% to 0.75%). There were no significant differences in the distribution of AB0 blood groups between immunized and nonimmunized patients. The greatest number of alloimmunized patients is at the age from 50 to 70 years. Immune alloantibodies are more often detected in women (1.10%) and Rh-negative patients than in men (0.55%) and Rh-positive patients (0.45%). The study did not reveal the production of alloantibodies in patients on days 5—7 and 12—14 after blood transfusion , even at transfusion of RBC with nonshared antigens (C, c, E, e).

The conclusion. It is desirable to investigate the presence of anti-erythrocyte alloantibodies before each blood transfusion, especially if blood transfusion is performed later than 12—14 days after the previous one. It is advisable to keep medical records (an extract from the hospital) with the data on the transfusions of donor erythrocyte-containing medium with the indication of their phenotype. 

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