OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press24310.17650/1818-8346-2017-12-2-70-79BASIC RESEARCHФУНДАМЕНТАЛЬНЫЕ ИССЛЕДОВАНИЯ В ПРАКТИЧЕСКОЙ МЕДИЦИНЕ НА СОВРЕМЕННОМ ЭТАПЕGENOTYPING OF AB0 AND Rh SYSTEMS BLOOD GROUPS IN PATIENTS AFTER MULTIPLE HEMOTRANSFUSIONSГЕНОТИПИРОВАНИЕ ГРУПП КРОВИ СИСТЕМ ABO И РЕЗУС У ПАЦИЕНТОВ ПОСЛЕ МНОЖЕСТВЕННЫХ ГЕМОТРАНСФУЗИЙKalandarovR. S.КаландаровР. С.
Russian Federation

4a Noviy Zykovskiy Proezd, Moscow 125167

Контакты: Рахман Самиевич Каландаров 

125167 Москва, Новый Зыковский проезд, 4а 

rkalandari@yandex.ruGolovkinaL. L.ГоловкинаЛ. Л.
Russian Federation

4a Noviy Zykovskiy Proezd, Moscow 125167

125167 Москва, Новый Зыковский проезд, 4а 

VasilievaM. N.ВасильеваМ. Н.
Russian Federation

4a Noviy Zykovskiy Proezd, Moscow 125167

125167 Москва, Новый Зыковский проезд, 4а 

StremouchovaA. G.СтремоуховаА. Г.
Russian Federation

4a Noviy Zykovskiy Proezd, Moscow 125167

125167 Москва, Новый Зыковский проезд, 4а 

PushkinaT. D.ПушкинаТ. Д.
Russian Federation

4a Noviy Zykovskiy Proezd, Moscow 125167

125167 Москва, Новый Зыковский проезд, 4а 

AtroshchenkoG. V.АтрощенкоГ. В.
Russian Federation

4a Noviy Zykovskiy Proezd, Moscow 125167

125167 Москва, Новый Зыковский проезд, 4а 

ParovichnikovaE. N.ПаровичниковаЕ. Н.
Russian Federation

4a Noviy Zykovskiy Proezd, Moscow 125167

125167 Москва, Новый Зыковский проезд, 4а 

Hematological Research Center, Ministry of Health of RussiaФГБУ «Гематологический научный центр» Минздрава России2706201712270792706201727062017https://oncohematology.abvpress.ru/ongm/article/view/243

Introduction. In patients after multiple blood transfusions, the serological determination of ABO and Rhesus blood groups becomes unreliable due to posttransfusion chimerism, i.e., circulation in the blood of two erythrocytes populations – own and donors. To solve this problem helps the genotyping of blood groups. The literature review includes 42 literature sources, including 9 Russian and 33 foreign articles.

Materials and methods. The authors typed blood samples of 24 patients with hematological disorders after numerous erythrocyte-containing transfusions. Antigens A and B, Rh D, Rh C/c, Rh E/e were determined by the serological method using monoclonal antibodies anti-A, antiB, anti-D, anti-C, anti-Cw , anti-c, E and anti-e (Moabs) (Hematologist, Russia). The presence of chimerism was established by hemagglutination typing in gel columns ID-Cards «DiaClon ABO / D + Reverse Grouping» and «DiaClon Rh-subgroups + K». The DNA extract was examined by PCR-SSP using commercial primers ABO-TYPE and RH-TYPE (BAG, Germany).

Results. In two patients with 50% chimerism with anti-A and anti-B monoclones, the ABO blood group was genotypically identified. Using molecular method presence of Rhesus system antigens was established in 24 patients with 20-95% chimerism for 1-5 antigens. Serological determination of blood groups at 4 months after the cessation of blood transfusions has confirmed all genotyping results.

Conclusion. Genotyping is advisable to use to determine the blood groups in patients after numerous erythrocyte-containing transfusions, which allows increasing immunological safety and preventing alloimmunization to clinically significant erythrocytes antigens.

Введение. У пациентов, перенесших множественные гемотрансфузии, серологическое определение групп крови систем ABO и резус становится невозможным вследствие посттрансфузионного химеризма, т. е. циркуляции в крови 2 популяций эритроцитов – собственных и донорских. Решить эту проблему помогает генотипирование групп крови. Обзор литературы включает 42 источника литуратуры, в том числе 9 отечественных и 33 зарубежных.

Материалы и методы. Образцы крови 24 гематологических больных, перенесших многочисленные трансфузии эритроцитсодержащих сред. Антигены А и В, Rh D, Rh C/c, Rh E/e определяли серологическим методом с применением моноклональных антител анти-А, анти-В, анти-D, анти-C, анти-Cw , анти-c, анти-E и анти-e (Moаbs) («Гематолог», Россия). Наличие химеризма устанавливали методом гемагглютинационного типирования в гелевых колонках ID–Cards «DiaClon ABO/D+Reverse Grouping» и «DiaClon Rh-subgroups+K». Экстракт дезоксирибонуклеиновой кислоты исследовали методом PCR-SSP с помощью коммерческих наборов с праймерами ABO-TYPE и RH-TYPE (BAG, Germany).

Результаты. У 2 пациентов с 50 % химеризмом, выявленным моноклональными антителами анти-A и анти-B, генотипически определена группа крови системы ABO. Молекулярный метод позволил идентифицировать генотип системы резус 24 больным, у которых серологическим методом выявлен процент смешанной популяции эритроцитов 20–95 по 1–5 антигенам. Определение групп крови серологическими методами через 4 мес после прекращения гемотрансфузий подтвердило все результаты генотипирования.

Заключение. Генотипирование целесообразно применять для определения групп крови пациентов, перенесших многочисленные трансфузии эритроцитсодержащих сред, что позволяет повысить иммунологическую безопасность и предотвратить аллоиммунизацию к клинически значимым групповым антигенам эритроцитов. 

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