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2018, Número 3

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Rev Cub de Tec de la Sal 2018; 9 (3)


Reacciones transfusionales asociadas a anticuerpos antigranulocíticos: aspectos fisiopatogénicos y moleculares del daño pulmonar agudo transfusional

Soler NG, Romero DY, Bencomo HA

Idioma: Español
Referencias bibliográficas: 50
Paginas: 66-81
Archivo PDF: 262.13 Kb.


RESUMEN

Introducción: existen sistemas antigénicos leucocitarios asociados a reacciones transfusionales. Los anticuerpos dirigidos contra algunos sistemas causan reacción transfusional febril no hemolítica y daño pulmonar agudo asociado a la transfusión. La pesquisa de estos anticuerpos es la estrategia para evaluar a los pacientes y donantes involucrados en estas reacciones. Objetivo: profundizar en las características fisiopatogénicas, diagnóstico y medidas de prevención del daño pulmonar agudo asociado a la transfusión. Métodos: se realizó una revisión de la literatura, a través del sitio web PubMed y el motor de búsqueda Google Académico, de artículos publicados en los últimos 10 años sobre el daño pulmonar agudo asociado a la transfusión. Se hizo un análisis y resumen de la bibliografía revisada. Desarrollo: en el daño pulmonar agudo asociado a la transfusión mediado por anticuerpos, es requisito que los presentes en el donante se unan al antígeno diana presente en el receptor, lo que conduce a la activación del complemento y causa secuestro pulmonar y activación de los neutrófilos. En algunos casos los anticuerpos no son detectados en el donante ni en el receptor. Los ensayos más empleados para la detección de anticuerpos anti-HNA son las técnicas de aglutinación, de inmunofluorescencia o citometría de flujo y la técnica de inmovilización de antígenos granulocíticos con anticuerpos monoclonales. Consideraciones finales: deben tomarse medidas preventivas para evitar la transfusión de productos sanguíneos que contengan anticuerpos antileucocitarios, a la vez que la identificación de los factores de riesgo perfeccionaría la estimación de riesgo-beneficio en este procedimiento terapéutico.


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