RASIO PREVALENSI ALLOANTIBODI PADA PASIEN TRANSFUSI BERULANG DIBANDING TIDAK BERULANG

Titien Budhiaty, dr. Teguh Triyono, MKes, SpPK(K)

2013 | Tesis | S2 Ked.Klinik/MS-PPDS

Transfusi darah dari donor allogenik berpotensi untuk memicu terbentuknya alloantibodi pada resipien karena adanya perbedaan antigen golongan darah antara donor dan resipien. Pasien-pasien thalassemia, hemodialisa, dan keganasan sebagian besar mengalami anemia selama sakitnya sehingga memerlukan transfusi eritrosit secara berulang. Hal ini meningkatkan risiko terbentuknya alloantibodi. Dari penelitian-penelitian sebelumnya didapatkan insiden alloantibodi bervariasi dari 4-60%. Akibat adanya alloantibodi ialah dapat menyebabkan reaksi transfusi hemolitik atau HDN. Tujuan penelitian ini adalah untuk mengetahui rasio prevalensi alloantibodi pada pasien transfusi berulang dibanding tidak berulang. Penelitian ini menggunakan disain potong lintang. Subyek penelitian terdiri dari dua kelompok yaitu kelompok dengan faktor risiko; terdiri dari pasien thalassemia, HD, dan keganasan yang mendapat transfusi berulang, dan kelompok tanpa faktor risiko; terdiri dari pasien yang mendapat transfusi tidak berulang. Sebanyak 72 subyek diikutkan dalam penelitian ini, masing-masing kelompok terdiri dari 36 subyek. Dilakukan skrining dan identifikasi antibodi pada kedua kelompok. Rasio prevalensi dianalisis dengan chi-square. Dilakukan analisis multivariat dengan regresi logistik terhadap faktor-faktor yang mempengaruhi terbentuknnya alloantibodi yaitu jenis kelamin, umur, diagnosis penyakit, jumlah transfuse, dan frekuensi transfusi. Diharapkan rasio prevalensi alloantibodi lebih dari 1 sehingga dapat memberikan evidence based pentingnya skrining antibodi pre-transfusi khususnya pada pasien transfusi berulang.

Allogenic blood transfusion has potential effect to trigger the formation of alloantibody in the recipient due to blood group antigen differences between donor and recipient. Thalassemia, hemodialysis, and malignancies patients get anemic during their illness, therefore requiring repeated and multiple erythrocyte transfusions. This increases the risk of developing alloantibody. Previous studies found that alloantibody incidence varies from 4-60%. The adverse event due to alloantibody is hemolytic transfusion reactions or HDN. The purpose of this study was to determine the prevalence ratio of alloantibody in patients with repeated transfusion compared to non repeated transfusion. This study used cross-sectional design. The study subjects consisted of two groups: the group with risk factors, consisting of thalassemia, HD, and malignancies patients who received repeated transfusions, and the group with no risk factors, consisting of patients who received transfusion only in once period. A total of 72 subjects were included in this study, each group consisted of 36 subjects. Screening and identification of antibodies were done in both groups. Prevalence ratio is analyzed with chi-square test. Logistic regression is performed to analyze the influence of other factors that contribute to alloantibody formation such as sex, age, diagnose, number of transfusion and frequency of transfusion. The prevalence ratio of the alloantibody was expected to be more than 1 in order to provide evidence-based of the importance of pre-transfusion antibody screening especially in patients with repeated and multiple transfusion

Kata Kunci : alloantibodi, transfusi berulang, rasio prevalensi