Author/Editor		Maček, Marjeta; Potočnik, Marjeta; Bricl, Irena; Urbajs, Matjaž; Rožman, Primož
Title		Imunohematološka obravnava škodljivih neželenih učinkov transfuzije krvi
Translated title		Immunohematological evaluation of transfusion reactions
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. Suppl 1
Publication year		2004
Volume		str. I-101-4
Language		slo
Abstract		Background. The decision, made by transfusion medicine specialist, for the extent of investigation of the transfusion reaction is based on the clinical course of transfusion reaction, reported by the patient's physician. Immunohaematological tests are used for testing of compatibility in red blood cells antigen and rarely also in platelet and leukocyte antigens. Evaluation of reported transfusion reactions includes repeated checking of patient identification, of issued component and of the compatibility in ABO blood groups between the patient and the donors. In cases of suspected immune haemolysis, direct antiglobulin test and antibody screening is performed from the patient's posttransfusion sample of blood. Whenever, due to the signs and simptoms of transfusion reaction and the results of testing, immune haemolysis is possible, additional immunohaematological tests are done. Conclusions. Specialist of transfusion medicine determines the type of transfusion reaction regarding the clinical course, the response to the treatment and the results of checking and testing. The evaluation is finished with a report for the patient's physician with further instructions. In addition, a report for the Consulting Service for Blood Component Users in Blood Transfusion Centre of Slovenia is issued. Described routine procedures of evaluation help us in the detection of the possible mistakes in the transfusion process and in the determination of the type of transfusion reaction.
Summary		Izhodišča. Transfuziolog se odloči za obseg preiskovanja neželenega škodljivega učinka transfuzije na osnovi poročila o kliničnem poteku, ki ga poda lečeči zdravnik. Z imunohematološkimi preiskavami rutinsko preverjamo predvsem skladnost v eritrocitnih antigenih, redkeje pa v trombocitnih in levkocitnih antigenih. Obravnava prijavljenih neželenih škodljivih učinkov transfuzije zajema ponovno preverjanje identifikacije bolnika, izdane komponente in skladnosti v krvnih skupinah ABO med prejemnikom in dajalcem. Pri sumu na imunsko hemolizo napravimo iz vzorca krvi, odvzetega po reakciji, direktni antiglobulinski test in presejalno testiranje na prisotnost eritrocitnih aloprotiteles. Z dodatnimi imunohematološkimi preiskavami nadaljujemo v primerih, ko je glede na simptome in znake reakcije ter dobljene izsledke imunska hemoliza verjetna. Zaključki. Transfuziolog glede na klinični potek, odziv na zdravljenje in izsledke preverjanj in preiskav opredeli vrsto transfuzijske reakcije. Obravnavo zaključimo s pisnim obvestilom lečečemu zdravniku, ki vsebuje nadaljnja priporočila, ter poročilom o neželenem škodljivem učinku, namenjenem Službi za svetovanje uporabnikom krvnih komponent na Zavodu RS za transfuzijsko medicino. Opisani rutinski postopki obravnave nam omogočajo odkritje morebitnih napak v postopku transfuzije in so v pomoč pri opredelitvi vrste neželenega škodljivega učinka transfuzije.
Descriptors		BLOOD TRANSFUSION HEMOLYSIS BLOOD GROUP INCOMPATIBILITY