RESUMEN
BACKGROUND: Alloimmunization is an adverse effect of blood transfusions. In Chile, alloimmunization frequency is not established, and for this reason the aim of this study was to investigate the prevalence and specificity of red blood cell (RBC) alloantibodies in Chilean transfused subjects. METHODS: Records from 4,716 multi-transfused patients were analyzed. In these patients, antibody screening was carried out prior to cross-matching with a commercially available two-cell panel by the microcolum gel test, and samples with a positive screen were analyzed for the specificity of the alloantibody with a 16-cell identification panel. RESULTS: The incidence of RBC alloimmunization in transfused patients was 1.02% (48/4,716) with a higher prevalence in women (40/48). We detected 52 antibodies, the most frequent specificities identified were anti-E (30.8%), anti-K (26.9%), anti-D (7.7%), and anti-Fy(a) (5.8%). The highest incidence of alloantibodies was observed in cancer and gastroenterology patients. CONCLUSION: The data demonstrated a low alloimmunization frequency in Chilean transfused patients, principally associated with antibodies anti-E, anti-K, anti-D, and anti-Fy(a).
RESUMEN
Antecedentes: El efecto de la tromboprofílaxis con heparina (HBPM o HNF) en pacientes de Medicina Interna no ha sido evaluado sistemáticamente. Métodos. Análisis de estudios aleatorizados sobre tromboprofílaxis en pacientes de Medicina Interna, excluyendo aquellos con Infarto Agudo del Miocardio o Enfermedad Cerebral Isquémica. Puntos Finales: Incidencia de TVP, EP clínico, EP fatal y efectos adversos. Resultados: Se seleccionaron cinco estudios que correspondieron a un total de 15328 pacientes, compararon heparina como medida tromboprofiláctica con placebo, observando una reducción no significativa en la incidencia de Embolismo Pulmonar Fatal (RR= 0.93 IC (0.87-1.08)). Hubo una disminución significativa en la incidencia de TVP y EP clínico con el uso de heparina, en comparación con los controles (RRA 9 por ciento y 0.66 por ciento) y un NNT de 11 y 151 pacientes, respectivamente. Se evidenció un aumento significativo en la incidencia de hemorragia mayor en el grupo de heparina (RR= 1.47 IC (1.22-1.73)). Conclusión: Este metaanálisis mostró que la tromboprofílaxis con heparina (HBPM o HNF) redujo la incidencia de TVP y EP clínico, sin ningún efecto significativo en EP fatal