Situation analysis and blood transfusion strategy of Lewis antibodies in Hunan Province

Xiaoxiang Wei; Fengxia Liu; Dong Ran; Ping Yin; Lin Qu

doi:10.15586/aei.v51i3.811

Xiaoxiang Wei

Department of Medicine Clinical Laboratory, Xiangya Third Hospital, Central South University, Changsha, China; Department of Blood Transfusion, The First People’s Hospital, Nanning, China.

Fengxia Liu

Department of Blood Transfusion, Xiangya Third Hospital, Central South University, Changsha, China.

Dong Ran

Department of Medicine Clinical Laboratory, The Eighth People’s Hospital, Nanning, China.

Ping Yin

Department of Blood Transfusion, Xiangya Third Hospital, Central South University, Changsha, China.

Lin Qu

Department of Medicine Clinical Laboratory, Xiangya Third Hospital, Central South University, Changsha, China.

Keywords

Antibody identification, blood transfusion strategy, Lewis antibody, RBC (red blood cells) transfusion, serological characteristics

Abstract

Background: Detection rate, serological characteristics, and clinical data of patients with Lewis blood group antibodies in Hunan Province were analyzed through retrospective analysis. This was undertaken in order to optimize the detection methods and blood transfusion strategies of these patients.

Methods: Blood typing, antibody screening, and cross-matching were performed by microcolumn gel, and Lewis antigen was detected by immediate spin test, antibody identification of positive and negative ABO samples, positive antibody screening, and cross-blood mismatch samples. Antibodies were identified by immediate spin test and microcolumn gel antiglobulin method, and the clinical data of the patients with Lewis antibody characteristics were analyzed.

Results: A total of 74 samples (15.91%) with Lewis antibodies were detected from 465 positive samples; cases were distributed in different cities of Hunan Province, with Changsha city being the most frequent (28%) one, with mostly non-O (66), anti-Le^a (31; 41.89%), anti-Le^a+anti-Le^b (23; 31.08%), anti-Le^b (5; 6.76%), anti-Le^bH and anti-Le^a+anti-Le^bH (1+4; 6.76%), and antibody types immunoglobulin M (IgM) (51; 68.92%), immunoglobulin G (8; 10.81%), and IgG+IgM (4; 5.41%) cases. Patients included more females (67.57%) than males. The detection rate of gynecological diseases and patients with solid tumors was highest (44.59%). In all cases, the Lewis blood group was Le (a-b-); none of the 15 transfusion patients had hemolytic transfusion reaction.

Conclusion: A variety of experimental methods must be adopted simultaneously to determine specificity and prevent the leakage of Lewis antibodies. The infusion of red blood cells matching with antiglobulin media at 37°C was recommended to ensure safe transfusion for recipients with Lewis antibodies.

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