(บทความวิจัย) ประสิทธิภาพของการให้โลหิตแบบจับคู่แอนติเจน ในโรงพยาบาลพระอาจารย์มั่น ภูริทัตโต เพื่อพัฒนาระบบการให้โลหิตในกลุ่มผู้ป่วยรับโลหิตประจำ

Rattanaporn Piyakapho

Authors

Rattanaporn Piyakapho Phra Ajarn Mun Bhuridatto Hospital, Sakon Nakhon Province, Thailand

Keywords:

Red blood cell alloimmunization prevention, Repeated transfusion, E antigen, c antigen, Mia antigen

Abstract

Red blood cell alloimmunization against non-ABO antigens, particularly Rh system antigens (E, c) and MNS system antigen (Mi^a), is a significant complication in repeatedly transfused patients that may lead to acute or delayed hemolytic transfusion reactions. A retrospective review at Phra Ajarn Mun Bhuridatto Hospital identified an alloimmunization rate of 2.38%, highlighting the need to establish a local antigen prevalence database and to evaluate the effectiveness of antigen-matched transfusion. A retrospective study was conducted in 180 repeatedly transfused patients at Phra Ajarn Mun Bhuridatto Hospital between October 2024 and March 2025, comprising 28 patients with thalassemia, 12 with chronic kidney disease, 5 with end-stage renal disease, and 135 with anemia from other causes. Antigen typing for E, c, and Mi^a was performed by the standard tube test. Antibody screening was performed at 1, 3, and 6 months following antigen-matched transfusion of E, c, and Mi^a. A total of 175 antigen-matched transfusion episodes (204 units) were recorded over the 6-month follow-up period. No new alloantibody formation was detected in any patient (0/180). Overall antigen prevalence was 33.3% (60 cases) for E, 25.6% (46 cases) for c, and 21.1% (38 cases) for Mi^a, respectively. Thalassemia patients showed a lower prevalence of c antigen at 14.3% (4/28) and Mi^a antigen at 3.6% (1/28) compared to other groups, respectively. These findings support the use of antigen-matched transfusion for E, c, and Mi^a as a standard of care for repeatedly transfused patients to reduce the risk of red blood cell alloimmunization.

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