E.V. FANASKOVA¹, O.V. GRUZDEVA^1,2, M.V. GONCHARENKO¹, T.Yu. PENSKAYA¹, A.A. KUZMINA¹, Yu.A. DYLEVA¹, E.G. UCHASOVA¹, O.L. BARBARASH^1,2

¹Research Institute for Complex Issues of Cardiovascular Disease, Kemerovo

²Kemerovo State Medical University, Kemerovo

 Contact details:

Fanaskova E.V. ― PhD (medicine), Junior Researcher of the Laboratory of Homeostasis Research Department for Diagnosis of Cardiovascular Diseases

Address: 6 Sosnoviy boulevard, Kemerovo, Russian Federation, 650002, tel. (3842) 64-05-53, e-mail: fanaskova70@mail.ru

 Due to hemorrhagic complications, about 50-60% of cardiac surgery patients in the perioperative period receive components of donor blood. However, transfusion of donor blood not only improves the patient’s condition, but also increases the risk of post-transfusion complications (VTE) deteriorating the results of surgical treatment. To ensure the safety of allohemotransfusions and prevent hemolytic post-transfusion complications, it is important to appropriately study the immune state of blood of the patients.

Objective ― to determine the frequency of occurrence of erythrocyte antigens (A, B, D, C, C^w, c, E, e, K), the index and the structure of allosensibilisation of patients of the cardiosurgical profile.

Material and methods. In 29931 blood samples of cardiac patients, were determined blood group system AB0, Rh-Hr, carried phenotyping for the antigens C, C^W, c, E, e, antigen K system Kell using monoclonal antibodies (Colyclons produced by Hematologist LLC, Moscow) by agglutination reaction on a plane, as well as by gel filtration using gel technology («Bio-Rad laboratories», USA, France), which was also used in detecting immune erythrocytic antibodies.

Results. Among the AB0 blood group system for commonly encountered 0 (I) (37.6%), followed by A (II) (33.2%), further in В (III) (21.6%) and AB (IV) (7.6%). Rh-positive individuals constituted 85.1% and Rh-negative ― 14.9%. Among the alloantibodies, most frequent were Rhesus antibodies (71.5%). Less frequent were antibodies to other systems: anti-K (8.8%), anti-M, S (5.8%), anti-Fy^a (1.0%), anti-Jk^a (1.0%), anti-Le^a, Le^b (2.0%). The estimated index of sensibilization among patients was 1.3%.

Conclusions. The findings show a high degree of alloimmunization persons surveyed and the potential risk of developing hemolytic-type post-transfusion complications.

Key words: alloimmunization, sensitization index, prevention of post-transfusion complications of hemolytic type.

REFERENCES

1. Dudkevich I.G. Opportunities for transfusion therapy and indications for its use. Vestnik sluzhby krovi Rossii, 2003, no. 3, pp. 18-21 (in Russ.).
2. Dashkova N.G. Sistema obespecheniya immunologicheskoy bezopasnosti gemokomponentnoy terapii: avtoref. dis. … dok. med. nauk [The system of ensuring the immunological safety of blood therapy. Synopsis of dis. Dr med. sciences]. Moscow, 2006. 47 p.
3. Mineeva N.V. Gruppy krovi cheloveka. Osnovy immunogematologii [Blood groups Basics of immunohematology]. Saint Petersburg, 2004. 188 p.
4. Prikaz Ministerstva Zdravookhraneniya Rossiyskoy Federatsii ot 09.01.1998 no. 2 “Ob utverzhdenii instruktsiy po immunoserologii” [Order of the Ministry of Health of the Russian Federation dated 09.01.1998 No. 2 “On approval of instructions for immuno-serology”].
5. Prikaz Ministerstva Zdravookhraneniya Rossiyskoy Federatsii ot 25.11.2002 no. 363 “Ob utverzhdenii instruktsii po primeneniyu komponentov krovi” [Order of the Ministry of Health of the Russian Federation of 25.11.2002 No. 363 «On approval of instructions for the use of blood components»].
6. Prikaz Ministerstva Zdravookhraneniya Rossiyskoy Federatsii ot 02.04.2013 no. 183n “Ob utverzhdenii pravil klinicheskogo ispol’zovaniya donorskoy krovi i (ili) ee komponentov” [Order of the Ministry of Health of the Russian Federation of April 2, 2013 N 183n “On approval of rules for the clinical use of donated blood and (or) its components”].
7. GOST 53470-2009 “Krov’ donorskaya i ee komponenty. Rukovodstvo po primeneniyu komponentov donorskoy krovi”, 2010 [GOST 53470-2009 “Donated blood and its components. Guidelines for the use of components of donor blood, 2010].
8. Donskov S.I., Lipatova I.S. Erythrocyte antigens alloimmunization — the global population process. Vestnik sluzhby krovi Rossii, 2001, no. 3, pp. 18-24 (in Russ.).
9. Donskov S.I., Bashlay A.G., Sudeykina N.N. et al. A modern view on the concept of compatible blood. Vestnik sluzhby krovi Rossii, 2004, no. 1, pp. 15-20 (in Russ.).
10. Donskov S.I., Gaponova T.V. Immunological safety of erythrocyte transfusion (development of the concept). Vestnik sluzhby krovi Rossii, 2013, no. 2, pp. 3-10 (in Russ.).
11. Donskov S.I., Gaponova T.V. Risk and prevention of posttransfusion complications caused by group erythrocyte antigens. Vestnik sluzhby krovi Rossii, 2013, no. 4, pp. 3-5 (in Russ.).
12. Umnova M.A. Gruppovye sistemy krovi cheloveka i gemotransfuzionnye oslozhneniya [Human blood group systems and blood transfusion complications]. Moscow: Meditsina, 1989. 160 p.
13. Donskov S.I., Kalandarov R.S., Dubinkin I.V. Distribution of transfusion-dangerous antigens of erythrocytes in the territory of the Russian Federation and neighboring countries. Vestnik sluzhby krovi Rossii, 2010, no. 4, pp. 33-36 (in Russ.).
14. Donskov S.I., Morokov V.A. Gruppy krovi cheloveka. Rukovodstvo po immunoserologii [Blood groups Guidelines for immunoserology]. Moscow: Binom, 2014. 1016 p.
15. Lipatova I.S. Alloimmunizatsiya gruppovymi antigenami eritrotsitov (individual’nye i populyatsionnye osobennosti): dis. … kand. med. nauk [Alloimmunization with group antigens of erythrocytes (individual and population features). Synopsis of dis. PhD med. sciences]. Moscow, 2009. 26 p.
16. Pashkova I.A., Kolomeytseva E.A., Ryzhanova L.G. et al. The organization of immunohematological research in a multidisciplinary hospital. Spravochnik zaveduyushchego KDL, 2012, no. 11, pp. 12-20 (in Russ.).
17. Agranenko V.A., Skachilova N.N. Gemotransfuzionnye oslozhneniya [Blood transfusion complications]. Moscow: Meditsina, 1986. 240 p.
18. Donskov S.I. Gruppy krovi sistemy Rhesus. Teoriya i praktika [Blood groups of the Rhesus system. Theory and practice]. Moscow: VINITI RAN, 2005. 392 p.
19. Vesnina N.V. Rh-antigeny eritrotsitov: alloimmunizatsiya i vliyanie na sostoyanie perifericheskogo zvena eritrona pri gemotransfuzii: avtoref. dis. … kand. med. nauk [Rh-antigens of erythrocytes: alloimmunization and the effect on the state of the peripheral link of erythrone during blood transfusion. Synopsis of dis. PhD med. sciences]. Tomsk, 2008. 23 p.
20. Epifanova A.A. Regional’nye immunogeneticheskie osobennosti donorskoy krovi: avtoref. dis. … kand. med. nauk [Regional immunogenetic features of donor blood. Synopsis of dis. PhD med. sciences]. Saratov, 2012. 24 p.
21. Pashkova I.A. Obespechenie kachestva gemotransfuzionnoy terapii v mnogoprofil’nom statsionare pri okazanii bol’nym vysokotekhnologichnoy khirurgicheskoy pomoshchi: avtoref. dis. … dokt. med. nauk [Ensuring the quality of blood transfusion therapy in a multidisciplinary hospital when providing patients with high-tech surgical care. Synopsis of dis. Dr med. sciences]. Saint Petersburg, 2014. 46 p.
22. Mineeva N.V., Pashkova I.A., Krobinets I.I. et al. Allosensitization to erythrocyte antigens (literature review). Onkogematologiya, 2015, no. 4 (10), pp. 60-65.
23. Fanaskova E.V., Gruzdeva O.V., Goncharenko M.V. et al. Providing immunological safety of blood transfusions during cardiac surgery. Klinicheskaya laboratornaya diagnostika, 2014, no. 12, pp. 40-44 (in Russ.).