Studies On Universal Blood Preparations By Removing Group ABO Blood Antibody

Compared to the blood preparations of the same group, universal blood preparations have many merits: without blood group examination and cross-matching of blood, saving time, decreasing hemolytic transfusion reaction, and can be transfused to any group patients. For group O blood, to ascertain the distribution of group ABO antibody, to choose the most suitable adsorbing substance, and to find the methods of removing adsorbing substance, then to provide safe group O blood for clinic is the key and nodus in the preparation of universal blood by removing group ABO blood antibody. Based on this idea the author carried out three studies:1. Distribution of group ABO antibody in group O RBC and whole blood. This study showed the distribution of group ABO antibody in group O RBC and whole blood in Beijing area, and the possibility of universal blood preparation. IgM antibody titers of 263 group O RBC samples and 255 whole blood samples in Beijing area were detected in saline, after IgM were destroyed by 2-Me, IgG antibody titers were detected by Polybrene test. The results showed that titers of anti-A antibody( IgM and IgG) distribute from 16 to 128, mainly 64, titers of anti-B antibody( IgM and IgG) distribute from 8 to 256, mainly 16,32 and 64.The distribution of group ABO antibody titers in group O RBC is similar with the distribution in group O whole blood. From the distribution of antibody titers, hemolytic reaction will be happened in 30% patients when they are transfused with group O blood, which residual anti-A/B antibody titers are more than 64 if titer 64 is seen as a safe titer. So to choose the most suitable group ABO antibody adsorbing substance is the next study idea.2. Study on group ABO antibody adsorbing substance: preparation, preservation and characteristics of freeze-drying RBC membrane. To ascertain group A/B RBC membrane to be group ABO antibody adsorbing substance. The study demonstrated that as freeze-drying protectant, trehalose can be better protecting the antigenicity of RBC membrane, lyophilized technology can protect the antigenicity of RBC membrane well (after freeze-drying, as antibody adsorbing substance, there's no any significant difference in antibody titers between before and after. P<0.01). To ascertain the most suitable reation conditions between rehydrated RBC membrane and group O plasma: under the room temperature (20±3℃) , react 25±5min, and the volume ratio is 1:10.3. Study on universal blood preparation. The study showed that adding group A, B RBC freeze-drying membrane respectively, the antibody titers of group A and B antibody in the plasma was decreased about 80% to99%, the quality indexes of red blood cells, such as morphology, deformability, the contents of ATP, osmotic fragility, as well as the contents of free Hb, were within a normal range, and showed no significant difference from those of normal red blood cells in group O RBC suspension (P>0. 05). The quality indexes of red blood cells, such as morphology, deformability, the contents of ATP, osmotic fragility, True choline esterase, as well as the contents of free Hb, were within a normal range, and showed no significant difference from those of normal red blood cells in group 0 whole blood (P>0. 05). The activity of blood coagulation factor V,VII,VIII also showed no any significant difference from those of normal blood coagulation factors in group O whole blood (P>0. 05). To study the remove methods of freeze-drying RBC membrane in group O RBC suspension and plasma, The study demonstrated that after proper centrifuge, the clearance rate of added frozen-drying membrane can be 77% in group O suspension, and by high speed centrifugation (3500 round/ min, 3min), the clearance rate of added frozen-drying membrane can be 95% in plasma.