Erythrocyte antigen kel1 in a new form of disease history

D. S. Pokhabov, A. Y. Fomina, E. B. Shestakov, E. B. Zhiburt
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Abstract

The accumulated scientific data on the clinical significance of phenotyping antigens of the Kell blood group system were studied. The Elibrary and Pubmed libraries were searched for articles using the keywords “Kell” and “transfusion”, and the validity of the requirement to determine the antigen of the Kell blood group system by current regulations was assessed.The purpose of the determination of the K antigen (KEL1) is practically not very clear. Theoretically, in a K-positive patient, zygosity should be determined by determining the k antigen (KEL2). With the KK phenotype, there is a risk of alloimmunization with the k antigen. However, it is extremely difficult to find a KK-positive donor compatible with ABO and RhD phenotypes. In fact, the risk of alloimmunization with the KEL2 antigen of a KK-positive recipient is considered acceptable and individual donor selection can be made for recipients of multiple transfusions or alloimmunized individuals.In the Elibrary library, 62 publications were found for the term “Kell”. None of them described a patient with the KK phenotype, let alone alloimmunization with the k antigen.Anti-k is rare, even in large laboratories 1 case is detected within several years of observation. The last transfusion hemolytic reaction caused by immunization to KEL2 was described in 1969.Conclusion. Russian regulations require the transfusion of RBCs that are compatible for the KEL1 antigen, but there is no definition of such “compatibility”. World and domestic historical experience testify to the possibility of transfusion to K-positive recipients, both K-positive and K-negative erythrocytes. If there are no K-positive donor erythrocytes in the hospital, the mandatory determination of the KEL1 antigen in potential recipients of donor blood can be excluded.
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一种新病史中的红细胞抗原 kel1
研究了有关 Kell 血型系统表型抗原临床意义的累积科学数据。以 "Kell "和 "输血 "为关键词在 Elibrary 和 Pubmed 图书馆检索了相关文章,并评估了现行法规要求测定 Kell 血型系统抗原的有效性。从理论上讲,对于 K 阳性患者,应通过测定 K 抗原(KEL2)来确定其血型。如果是 KK 表型,则有与 k 抗原发生同种免疫的风险。然而,要找到一个与 ABO 和 RhD 表型相容的 KK 阳性供体是非常困难的。事实上,KK 阳性受血者 KEL2 抗原的同种免疫风险被认为是可以接受的,对于多次输血的受血者或同种免疫者,可以对供体进行个体选择。其中没有一篇描述了 KK 表型的患者,更不用说 K 抗原的同种免疫了。抗 K 的情况非常罕见,即使在大型实验室中,也只能在数年的观察期内发现一例。上一次由 KEL2 免疫引起的输血溶血反应是在 1969 年。俄罗斯的法规要求输注与 KEL1 抗原相容的红细胞,但对这种 "相容 "没有定义。世界和国内的历史经验证明,可以向 K 阳性受体输注 K 阳性和 K 阴性红细胞。如果医院中没有 K 阳性的献血者红细胞,则可以排除对潜在的献血者受血者进行 KEL1 抗原的强制性检测。
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