A and B antigen levels acquired by group O donor-derived erythrocytes following ABO-non-identical transfusion or minor ABO-incompatible haematopoietic stem cell transplantation

作者：Hult A K; Dykes J H; Storry J R; Olsson M L^*

来源：Transfusion Medicine, 2017, 27(3): 181-191.

DOI：10.1111/tme.12411

• ABO blood group antigen
• red blood cell
• haematopoietic stem cell transplantation
• glycosphingolipids
• flow cytometry

Background and Objectives: ABO-incompatible haematopoietic stem cell transplantation (HSCT) presents a challenge to blood component transfusion. The aim of this study was to investigate the weak blood group A or B antigen expression by donor-derived group 0 red blood cells (RBC) observed following transfusion or minor ABO-incompatible HSCT. In addition, in vitro experiments were performed to elucidate possible mechanisms underlying this phenomenon.
Materials and Methods: A sensitive flow cytometry assay for the semi-quantification of RBC A/B antigen levels was used to assess patient samples and evaluate in vitro experiments.
Results: Analysis of blood samples from patients, originally typed as A, B and AB but recently transplanted or transfused with cells from group 0 donors, revealed the A antigen expression on donor-derived RBC, ranging from very low levels in non-secretor individuals to almost subgroup A(x)-like profiles in group A secretors. The B antigen expression was less readily detectable. In vitro experiments, in which group 0 donor RBC were incubated with (i) group A/B secretor/non-secretor donor plasma or (ii) group A/B donor RBC in the absence of plasma, supported the proposed adsorption of A/B antigen-bearing glycolipids from secretor plasma but also indicated a secretor-independent mechanism for A/B antigen acquisition as well as direct cell-to-cell transfer of ABO antigens.
Conclusion: The in vivo conversion of donor-derived blood group ORBC to ABO subgroup-like RBC after transfusion or minor ABO-incompatible HSCT raises the question of appropriate component selection. Based on these data, AB plasma should be transfused following ABO-incompatible HSCT.

• 出版日期2017-6