中国输血杂志2025，Vol.38Issue(11)：1556-1561,6.DOI:10.13303/j.cjbt.issn.1004-549x.2025.11.012
RhD初筛阴性献血者意外抗体回顾性分析
Retrospective analysis of unexpected antibodies in primary-screened D-negative blood donors
摘要
Abstract
Objective To analyze the frequency and investigate the causes of unexpected antibodies in D-negative blood donors.Methods From January 2022 to December 2024,3 768 D-negative blood donors sent to our laboratory were select-ed as research subjects.D-negative confirmation test and RhCE phenotype detection were applied by saline tube method and microcolumn gel indirect antiglobulin test(IAT),respectively.Antibody screening and identification were performed using the polybrene method and IAT column agglutination methods.Anti-D,anti-C and anti-G specificities were identified by a two-step adsorption-elution method,and the genotypes of D-negative samples were determined by RHD gene amplification,Sanger sequencing,and PacBio Single Molecule Real-Time(SMRT)sequencing.Results Among D-negative donors,ccee and Ccee phenotypes accounted for the highest proportion,55.68％(2 098/3 768)and 29.56％(1 114/3 768),re-spectively,while CcEE and CCEe phenotypes were the least,with one case detected in each,accounting for 0.03％(1/3 768).A total of 165 cases with D variant phenotype were detected,and the proportion of D variant was 4.38％(165/3 768)in the donors detected by D-negative confirmation test.Antibody screening positive blood donors were identified in 93 cases with a proportion of 2.47％(93/3 768).Antibody specificity was determined in 84 blood donors,and 9 samples showed no clear specificity.Anti-D was detected most frequently(n=68),in which 6 of them were detected having multi-ple antibodies,anti-D+anti-C(n=2),anti-D+anti-G(n=1),and anti-D+anti-E(n=3).The other antibodies detected were anti-E(n=1),anti-M(n=9),anti-P1(n=3),anti-Lea(n=1),and anti-HI(n=2).Fourteen cases were detected with anti-D in serological D-negative donors with C+or E+phenotype,in which three of them were DVI type 3 individuals and 11 cases were D negative individuals.Conclusion The incidence of unexpected antibodies was higher in D-negative blood donors than in the total donors,with anti-D being the most common.The data provide insights for prevention and mo-nitoring hemolytic disease of the fetus and newborn(HDFN)caused by anti-D.To ensure the safety of blood transfusion,routine unexpected antibody screening for RhD-negative blood donors is recommended to prevent the use of unexpected anti-bodies positive plasma in the clinic.关键词
Rh血型/RhD阴性/献血者/意外抗体Key words
Rh blood group/D-negative/blood donor/unexpected antibody分类
医药卫生引用本文复制引用
杨贺才,关茵,马晓莉,吕永磊,耿明璐,曹轶,王丽萍,马宏伟..RhD初筛阴性献血者意外抗体回顾性分析[J].中国输血杂志,2025,38(11):1556-1561,6.基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20220260,LHGJ20240596) （LHGJ20220260,LHGJ20240596）
