Abstract：
BACKGROUND: Prehospital low-titer group O whole blood (LTOWB) used for patients with life-threatening hemorrhage is often RhD positive. The most important complication following RhD alloimmunization is hemolytic disease of the fetus and newborn (HDFN). Preceding clinical use of RhD positive LTOWB, we estimated the risk of HDFN due to LTOWB prehospital transfusion in the Finnish population.
METHODS: We collected data on prehospital transfusions in Tampere and Helsinki University Hospital areas. Using the mean of reported alloimmunization rates in trauma studies (24%) and a higher reported rate representing trauma patients of 13-50 years old (42.7%), we estimated the risk of HDFN and extrapolated it to the whole of Finland.
RESULTS: We estimated that in Finland, with the current prehospital transfusion rate we would see 1-3 cases of severe HDFN due to prehospital LTOWB transfusions every 10 years, and fetal death due to HDFN caused by LTOWB transfusion less than once in 100 years.
CONCLUSIONS: The estimated risk of serious HDFN due to prehospital LTOWB transfusion in the Finnish population is similar to previous estimates. As Finland routinely screens expectant mothers for red blood cell antibodies and as the contemporary treatment of HDFN is very effective, we support the prehospital use of RhD positive LTOWB in all patient groups.
METHODS: We collected data on prehospital transfusions in Tampere and Helsinki University Hospital areas. Using the mean of reported alloimmunization rates in trauma studies (24%) and a higher reported rate representing trauma patients of 13-50 years old (42.7%), we estimated the risk of HDFN and extrapolated it to the whole of Finland.
RESULTS: We estimated that in Finland, with the current prehospital transfusion rate we would see 1-3 cases of severe HDFN due to prehospital LTOWB transfusions every 10 years, and fetal death due to HDFN caused by LTOWB transfusion less than once in 100 years.
CONCLUSIONS: The estimated risk of serious HDFN due to prehospital LTOWB transfusion in the Finnish population is similar to previous estimates. As Finland routinely screens expectant mothers for red blood cell antibodies and as the contemporary treatment of HDFN is very effective, we support the prehospital use of RhD positive LTOWB in all patient groups.
摘要：
背景：院前低滴度O组全血（LTOWB）用于危及生命的出血患者通常是RhD阳性。RhD同种免疫后最重要的并发症是胎儿和新生儿的溶血病（HDFN）。在临床使用RhD阳性LTOWB之前，我们估计了芬兰人群因LTOWB院前输血导致HDFN的风险.
方法：我们收集了坦佩雷和赫尔辛基大学医院院前输血的数据。使用创伤研究中报告的同种免疫率的平均值（24％）和代表13-50岁创伤患者的较高报告率（42.7％），我们估计了HDFN的风险，并将其推断到整个芬兰。
结果：我们估计在芬兰，根据目前的院前输血率，我们将每10年看到1-3例由于院前LTOWB输血导致的严重HDFN，和由LTOWB输血引起的HDFN引起的胎儿死亡少于100年一次。
结论：芬兰人群因院前LTOWB输血导致严重HDFN的估计风险与以前的估计相似。由于芬兰常规筛查孕妇的红细胞抗体，并且由于HDFN的当代治疗非常有效，我们支持在所有患者组中院前使用RhD阳性LTOWB.
方法：我们收集了坦佩雷和赫尔辛基大学医院院前输血的数据。使用创伤研究中报告的同种免疫率的平均值（24％）和代表13-50岁创伤患者的较高报告率（42.7％），我们估计了HDFN的风险，并将其推断到整个芬兰。
结果：我们估计在芬兰，根据目前的院前输血率，我们将每10年看到1-3例由于院前LTOWB输血导致的严重HDFN，和由LTOWB输血引起的HDFN引起的胎儿死亡少于100年一次。
结论：芬兰人群因院前LTOWB输血导致严重HDFN的估计风险与以前的估计相似。由于芬兰常规筛查孕妇的红细胞抗体，并且由于HDFN的当代治疗非常有效，我们支持在所有患者组中院前使用RhD阳性LTOWB.
