Abstract：
The D-alloimmunization rate in trauma patients does not appear to depend on the number of RhD-positive units transfused. The effect of the timing and pattern of RhD-positive transfusions has not been evaluated.
RhD-negative trauma patients who were transfused with RhD-positive red blood cells (RBC) or low titer group O whole blood (collectively called RBCs) on at least two separate calendar days and who had antibody detection tests performed at least 14 days after the second RhD-positive RBC transfusion without receiving RhIg were included in the analysis. Patients whose anti-D was detected within 14 days of the index RhD-positive RBC transfusion were excluded. Patient demographics and the dates of RhD-positive RBC transfusions and results of antibody detection tests performed after the index transfusion were collected on eligible patients.
There were 44/61 (72.1%) patients in whom anti-D was not detected (non-alloimmunized) and 17/61 (27.9%) in whom anti-D was detected (alloimmunized). The patients had similar demographics with trends towards higher median admission heart rates and lower median admission Glasgow Coma Scale values in the alloimmunized group. Both groups received statistically identical median quantities of RhD-positive RBCs (non-alloimmunized 5 vs. alloimmunized 4 units, p = .53), however, the alloimmunized group received all their RhD-positive RBCs over a significantly shorter period of time compared to the non-alloimmunized (median 4 vs. 15 days, respectively, p = .01).
Receipt of all RhD-positive RBCs over a shorter period of time was associated with higher D-alloimmunization rates. These results need to be confirmed in larger studies.
RhD-negative trauma patients who were transfused with RhD-positive red blood cells (RBC) or low titer group O whole blood (collectively called RBCs) on at least two separate calendar days and who had antibody detection tests performed at least 14 days after the second RhD-positive RBC transfusion without receiving RhIg were included in the analysis. Patients whose anti-D was detected within 14 days of the index RhD-positive RBC transfusion were excluded. Patient demographics and the dates of RhD-positive RBC transfusions and results of antibody detection tests performed after the index transfusion were collected on eligible patients.
There were 44/61 (72.1%) patients in whom anti-D was not detected (non-alloimmunized) and 17/61 (27.9%) in whom anti-D was detected (alloimmunized). The patients had similar demographics with trends towards higher median admission heart rates and lower median admission Glasgow Coma Scale values in the alloimmunized group. Both groups received statistically identical median quantities of RhD-positive RBCs (non-alloimmunized 5 vs. alloimmunized 4 units, p = .53), however, the alloimmunized group received all their RhD-positive RBCs over a significantly shorter period of time compared to the non-alloimmunized (median 4 vs. 15 days, respectively, p = .01).
Receipt of all RhD-positive RBCs over a shorter period of time was associated with higher D-alloimmunization rates. These results need to be confirmed in larger studies.
摘要：
背景：创伤患者的D-同种免疫率似乎并不取决于输注的RhD阳性单位的数量。尚未评估RhD阳性输血的时机和模式的影响。
方法：RhD阴性创伤患者在至少两个独立的日历日输注了RhD阳性红细胞（RBC）或低滴度O组全血（统称为RBC），并且在第二次RhD阳性RBC输注后至少14天进行了抗体检测测试，但未接受RhIg。排除在RhD阳性RBC输注后14天内检测到抗D的患者。收集符合条件的患者的人口统计学和RhD阳性RBC输血的日期以及指数输血后进行的抗体检测测试的结果。
结果：有44/61（72.1％）患者未检测到抗D（非同种免疫）和17/61（27.9％）患者检测到抗D（同种免疫）。在同种免疫组中，患者的人口统计学特征相似，中位入院心率较高，中位入院格拉斯哥昏迷评分值较低。两组均接受统计学上相同的RhD阳性红细胞中位数（非同种免疫5与免疫了4个单位，p=.53)，然而,与非同种免疫组相比，同种免疫组接受了所有RhD阳性红细胞的时间明显更短(中位数4vs.15天,分别,p=.01）。
结论：在较短时间内接受所有RhD阳性红细胞与较高的D-同种免疫接种率相关。这些结果需要在更大的研究中得到证实。
方法：RhD阴性创伤患者在至少两个独立的日历日输注了RhD阳性红细胞（RBC）或低滴度O组全血（统称为RBC），并且在第二次RhD阳性RBC输注后至少14天进行了抗体检测测试，但未接受RhIg。排除在RhD阳性RBC输注后14天内检测到抗D的患者。收集符合条件的患者的人口统计学和RhD阳性RBC输血的日期以及指数输血后进行的抗体检测测试的结果。
结果：有44/61（72.1％）患者未检测到抗D（非同种免疫）和17/61（27.9％）患者检测到抗D（同种免疫）。在同种免疫组中，患者的人口统计学特征相似，中位入院心率较高，中位入院格拉斯哥昏迷评分值较低。两组均接受统计学上相同的RhD阳性红细胞中位数（非同种免疫5与免疫了4个单位，p=.53)，然而,与非同种免疫组相比，同种免疫组接受了所有RhD阳性红细胞的时间明显更短(中位数4vs.15天,分别,p=.01）。
结论：在较短时间内接受所有RhD阳性红细胞与较高的D-同种免疫接种率相关。这些结果需要在更大的研究中得到证实。
