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dc.contributor.authorSantos, Lorena Alves-
dc.date.available2023-11-08-
dc.date.available2023-11-21T13:09:17Z-
dc.date.issued2023-08-31-
dc.identifier.urihttp://repositorioinstitucional.uea.edu.br//handle/riuea/5346-
dc.description.abstractThe most frequent late transfusion reactions are alloimmunization and hemolysis, observed in up to 70% of patients with sickle cell disease (SCD) who received multiple transfusions. The immunohematological profile of these reactions is characterized by the identification of alloimmunization, with or without the presence of hemolysis through tests such as a positive irregular antibody test, indicating a potentially hemolytic antibody specific for blood group systems such as Rh, Kell, Kidd, Duffy and MNS. Objective: To characterize the immunohematological profile of late transfusion reactions in patients with sickle cell disease who received multiple transfusions. Methodology: Prospective descriptive observational study of these patients, including children, adults and elderly people of both sexes undergoing chronic transfusion therapy. Patients with multiple transfusions exposed to three or more units of blood products during twelve months. Results and Discussion: 44 patients with multiple transfusions were included in the project, the majority of whom were female (54.5%), adults (40.9%) and type O (61.3%) of the ABO system. Regarding the phenotyping of blood group systems, the most significant results from a transfusion point of view were found in the Rh system, a frequency of 26.6% of the RZRZ phenotype (CDE/CDE), a patient with the RHD variant presenting anti-RhD and a patient with RHCE variant (R1 wR1) presenting anti-e l and anti-E. As for the Kell system, 61.3% presented K-k+, with considerable difficulty in finding compatible blood donors in these cases. Among the patients included, 20.4% presented one or more alloantibodies, showing late alloimmunization reactions, 9% presented autoantibodies, suggesting a possible late immunomodulation reaction. Regarding the verification of post-transfusion hematological tests, 31.8% of patients presented laboratory indicators of post-transfusion Hemolysis with the result of altered DHL and 54.5% presented a very low increase in hemoglobin after blood transfusions, suggesting possible delayed hemolytic reactions. Conclusion: The results of this study demonstrate the characterization of the immuno-hematological profile of late alloimmunization and hemolytic transfusion reactions in patients with Sickle Cell Disease who received multiple transfusions treated at the Hematology and Hemotherapy foundation from Amazonas, constituting unprecedented data obtained during clinical-laboratory follow-up up to 28 days after transfusionspt_BR
dc.languageporpt_BR
dc.publisherUniversidade do Estado do Amazonaspt_BR
dc.rightsAcesso Abertopt_BR
dc.subjectReação transfusional tardiapt_BR
dc.subjectAloanticorpopt_BR
dc.subjectHemólise tardiapt_BR
dc.subjectSistema de grupos sanguíneospt_BR
dc.subjectPolitransfundidopt_BR
dc.subjectDelayed transfusion reactionpt_BR
dc.titleCaracterização do perfil imuno-hematológico das reações transfusionais tardias em pacientes com doença falciforme politransfundidos no Hemocentro do Amazonaspt_BR
dc.title.alternativeCharacterization of the immunohematological profile of late transfusion reactions in patients with sickle cell disease who received multiple transfusions at the Hemocentro do Amazonaspt_BR
dc.typeDissertaçãopt_BR
dc.date.accessioned2023-11-21T13:09:17Z-
dc.contributor.advisor1Albuquerque, Sergio Roberto Lopes-
dc.contributor.advisor1Latteshttp://lattes.cnpq.br/7446141046261325pt_BR
dc.contributor.referee1Albuquerque, Sergio Roberto Lopes-
dc.contributor.referee1Latteshttp://lattes.cnpq.br/7446141046261325pt_BR
dc.contributor.referee2Moura Neto, José Pereira de-
dc.contributor.referee2Latteshttp://lattes.cnpq.br/6749773067557179pt_BR
dc.contributor.referee3Mota, Mariza Aparecida-
dc.contributor.referee3Latteshttp://lattes.cnpq.br/0310956897955111pt_BR
dc.description.resumoAs reações transfusionais tardias mais frequentes são aloimunização e hemólise, sendo observada em até 70% dos pacientes com doença falciforme (DF) politransfundidos. O perfil imuno-hematológico destas reações é caracterizado pela identificação da aloimunização, com presença ou não de hemólise através de testes como pesquisa de anticorpo irregular (PAI) positivo, indicando anticorpo potencialmente hemolítico específico para os sistemas de grupos sanguíneos tais como Rh, Kell, Kidd, Duffy e MNS. Objetivo: Caracterizar o perfil imuno-hematológico das reações transfusionais tardias em pacientes com doença falciforme politransfundidos. Metodologia: Estudo observacional descritivo prospectivo destes pacientes, incluindo crianças, adultos e idosos de ambos os sexos em terapia transfusional crônica. Pacientes com DF politransfundidos expostos a três ou mais unidades de hemocomponentes durante doze meses. Resultados e Discussão: Foram incluídos no projeto 44 pacientes com DF politransfundidos, os quais a maioria pertencia ao gênero feminino (54,5%), adultos (40,9%) e do tipo O (61,3%) do sistema ABO. Quanto à fenotipagem dos sistemas de grupos sanguíneos, os resultados mais significantes do ponto de vista transfusional, foram encontrados no sistema Rh, frequência de 26,6% do fenótipo RZRZ (CDE/CDE), um paciente com variante RHD apresentando anti-RhD e um paciente com variante RHCE (R1 wR1) apresentando anti-e e anti-E. Quanto ao sistema Kell, 61,3% apresentaram K-k+, com considerável dificuldade para se encontrar doadores de sangue compatíveis nestes casos citados. Entre os pacientes incluídos, 20,4% apresentaram um ou mais aloanticorpos, evidenciando reações tardias de aloimunização de, 9% apresentaram de autoanticorpos, sugerindo uma possível reação tardia de imunomodulação. Quanto a verificação de exames hematológicos pós transfusionais, 31,8% dos pacientes apresentaram indicadores laboratoriais de Hemólise pós transfusional com o resultado de DHL alterada e 54,5% apresentando baixíssimo incremento de hemoglobina após as transfusões de sangue, sugerindo possíveis reações Hemolíticas Tardias. Conclusão: Os resultados deste estudo demonstram a caracterização do perfil imuno-hematológico de reações transfusionais tardias de aloimunização e hemolítica em pacientes com Doença Falciforme politransfundidos tratados na Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, constituindo-se dados inéditos obtidos durante acompanhamento clínico-laboratorial até 28 dias após as transfusões.pt_BR
dc.publisher.countryBrasilpt_BR
dc.publisher.programPPGH -PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS APLICADAS À HEMATOLOGIApt_BR
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