CONCEPT OF THE SELECTION OF COMPATIBLE BLOOD DURING THE TRANSFUSION OF ERYTHROCYTE CONTAINING MEDIA

N.G.DASHKOVA, A.A.RAGIMOV, M.N.ORATOVSKI

Department of the Russian Academy of Medical Sciences, Russian Scientific Center of Surgery named after academician Petrovsky RAMS, RUSSIA

In everyday transfusion practice there is a number of outstanding incompatible problems – efficiency, re, effectiveness, reasonability, efficiency, aimed at ensuring the safety of blood transfusions.

For the settlement of the problems the tactic of the selection of compatible blood is proposed. After determining the blood group by ABO method and Rhesus of donor and recipient it is advisable to adhere to the following algorithm of immunohematologic certification:

1. Prior to blood transfusions all patients must be held individual selection of blood for compatibility in an indirect test with AGS and salt samples carried out at 4-8^ОС, 20-22 ^ОС and 37 ^ОС.

2. Serum of patients with transfusion burdened and / or obstetric history, and patients requiring blood transfusions in multiple hemotransfusions, should be further tested for the presence of alloimmunne antibodies (thermal, cold, enzyme-dependent) with the identification of their specificity and immunoglobulin classes (IgG and IgM). Given the identified specificity of the immune alloantibodies selection of typed blood containing no antibodies to the antigens of the recipient shall be provided. Before blood transfusions an individual selection of blood for compatibility in an indirect test with ACS and salt samples (4-8^ОС, 20-22 ^ОС and 37 ^ОС) shall be carried out.

In accordance with the proposed algorithm, in 2005 – 2009 there was carried out selection concentrated red cells for 73 888 recipients (3794 husband. and 3594 women).

The proposed algorithm allows to solve research problems and features of blood transfusion connected especially with hemotransfusion provision of surgical patients, operated under the conditions of hypothermia up to 16 - 28^OS. In these situations, a special urgency was acquired by antierythrocytic antibody media, is a selection of a donor-recipient pair in indirect sample with AGS and salt samples at 4-8 ^ОС or room temperature - 20-23 ⁰C.

Performed researches, analysis of the results, mathematical processing of data and literature allowed to determine that the selection of donor-recipient pairs in an indirect test with AGS and salt samples (at при 4-8^ОС, 20-22 ^ОС и 37 ^ОС) performed in a specialized laboratory is basic criterion providing the maximum immunohematologic safety of hemotransfusions of erythrocyte containing media.

Date: 2014-12-28; view: 954