Kháng thể bất thường ở người hiến máu: Tỷ lệ hiện mắc, ý nghĩa lâm sàng và các chiến lược giảm thiểu rủi ro

Irregular antibodies (IAs) in blood donors pose a significant challenge to transfusion safety worldwide, necessitating mandatory screening for all donated blood units. While their prevalence might appear low, undetected IAs can lead to severe acute or delayed hemolytic transfusion reactions, especially in vulnerable patient populations such as those with thalassemia, aplastic anemia, or neonates. This article aims to provide a comprehensive overview by compiling domestic and international data on the prevalence and characteristics of IAs. Furthermore, it analyzes their crucial clinical significance and proposes practical risk-reduction strategies tailored for implementation within Vietnam's healthcare system, contributing to enhanced blood safety and a modernized blood banking infrastructure.

Transfusion medicine specialists, hematologists, blood bank professionals, researchers, and policymakers in public health and healthcare administration.

This academic paper thoroughly examines irregular antibodies (IAs) in blood donors, highlighting their prevalence, clinical significance, and risk mitigation strategies. It compiles extensive data, revealing global IA prevalence ranging from 0.046% to 0.77%, with rates in Vietnam between 0.06% and 0.37%. The text categorizes IAs by immunoglobulin class (IgG, IgM), complement activation potential, and optimal temperature, noting the critical clinical implications of IgG antibodies, particularly their association with hemolytic disease of the fetus and newborn (HDFN) and various transfusion reactions. The article details specific clinically significant antibodies, including those from the Rh, Kell, Duffy, Kidd, and MNS systems, and discusses the nuanced impact of anti-Mia, prevalent in some Asian populations. The core of the paper focuses on comprehensive strategies to mitigate risks. These include mandatory routine screening of all blood donations, utilizing advanced techniques like Solid Phase Red Cell Adherence (SPRCA) and Erythrocyte Magnetized Technology (EMT) for accurate detection. Key recommendations involve establishing robust systems for antibody identification and archiving donor profiles, implementing donor follow-up programs, and ensuring interdisciplinary coordination to provide antigen-matched blood for high-risk patients. The management of IA-positive blood units and donor notification are also addressed. Ultimately, these measures are crucial for improving transfusion safety, enhancing the efficacy of transfusions, and contributing to the development of a modern, standardized blood banking system in Vietnam, emphasizing continuous research and standardization nationwide.