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닔삁쓽븰寃궗 떊鍮숇룄議곗궗 寃곌낵蹂닿퀬(2016)
Annual Report on the External Quality Assessment Scheme for Immunohematology Testing in Korea (2016)
J Lab Med Qual Assur 2017;39:107-116
Published online September 30, 2017
© 2017 Korean Association of External Quality Assessment Service.

엫쁺븷, 議고쁽닔
Young Ae Lim, Hyun Soo Cho

븘二쇰븰援 쓽怨쇰븰 븘二쇰븰援먮퀝썝 吏꾨떒寃궗쓽븰怨

Department of Laboratory Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
Correspondence to: Young Ae Lim Department of Laboratory Medicine, Ajou University Hospital, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon 16499, Korea Tel: +82-31-219-5786 Fax: +82-31-219-5778 E-mail: limyoung@ajou.ac.kr
援먯떊옄: 엫쁺븷 슦)16499 寃쎄린룄 닔썝떆 쁺넻援 썡뱶而듬줈 164, 븘二쇰븰援 쓽怨쇰븰 븘二쇰븰援먮퀝썝 吏꾨떒寃궗쓽븰怨 Tel: 031)219-5786, Fax: 031)219-5778, E-mail: limyoung@ajou.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

2016뀈뿉 떆뻾맂 닔삁쓽븰寃궗뿉 븳 떊鍮숇룄議곗궗寃곌낵瑜 蹂닿퀬븯怨좎옄 븳떎. 寃泥대뒗 븘二쇰븰援먮퀝썝뿉꽌 吏곸젒 젣議고븯뿬 李몄뿬湲곌뱾뿉寃 뿰 2쉶 諛쒖넚븯떎. 10媛쒖쓽 룊媛醫낅ぉ뿉 븳 젙떟瑜좎(룊洹 李몄뿬湲곌 닔) 떎쓬怨 媛숈븯떎. ABO 삁븸삎寃궗 98.9%-99.7% (627媛), RhD 삁븸삎寃궗 98.6%-99.8% (607媛), 援먯감떆뿕寃궗 90.1%-98.1% (454媛), ABO 븘삎 삁븸삎 92.7%-93.0% (42媛), Rh CcEe 빆썝寃궗 97.8%-100.0% (46媛), 빟 D寃궗 70.8%-73.6% (91媛), 鍮꾩삁湲고빆泥 꽑蹂꾧궗 96.6%-100.0% (267媛), 吏곸젒빆湲濡쒕텋由곌궗뒗 떎듅씠꽦 92.2%-99.6% (249媛), 떒듅씠꽦 immunoglobulin G 84.1%-100.0% (68媛), 洹몃━怨 떒듅씠꽦 C3d 80.0%-100.0% (68媛), 鍮꾩삁湲고빆泥 룞젙寃궗 96.7%-99.1% (118媛), 洹몃━怨 ABO 빆泥 뿭媛寃궗 82.4%-100.0% (42媛)떎. 빟 D寃궗瑜 젣쇅븳 2016뀈룄 닔삁쓽븰寃궗쓽 떊鍮숇룄寃곌낵뒗 슦닔븳 렪씠뿀쑝硫, 李몄뿬 寃궗떎쓽 吏 뼢긽뿉 湲곗뿬븯떎.

We report here the 2016 results of surveys on an external quality assessment (EQA) for immunohematology testing in Korea carried out in 2016. The proficiency testing specimens were prepared at Ajou University Hospital, and the specimens were sent to participants biannually. The average accuracy rates (N=the number of participants) for ten different test items on the regular survey were as follows: ABO typing, 98.9%99.7% (N=627); RhD typing, 98.6%99.8% (N=607); crossmatching, 90.1%98.1% (N=454); ABO subtyping, 92.7%93.0% (N=42); Rh CcEe antigen testing, 97.8%100.0% (N=46); weak D test, 70.8%73.6% (N=91); antibody screening, 96.6%100.0% (N=267); direct antiglobulin test (DAT) using a polyspecific reagent, 92.2%99.6% (N=49); DAT using an immunoglobulin G monospecific reagent, 84.1%100.0% (N=68); DAT using a C3d monospecific reagent, 80.0%100.0% (N=68); antibody identification, 96.7%99.1% (N=118); and ABO antibody titration, 82.4%100.0% (N=42). Excellent results for the 2016 EQA for immunohematology testing were obtained, except for those of the weak D test. The EQA for immunohematology testing in 2016 should be helpful for improving the quality of participating laboratories.

Keywords : Transfusion medicine, Assessment of quality, Laboratory proficiency testing
꽌 濡

닔삁 솚옄쓽 깮紐낃낵 뿰愿맂 以묒슂븳 떆닠뻾쐞濡 닔삁 쟾 寃궗뒗 젙솗꽦씠 蹂댁쬆릺뼱빞 븳떎. 삁븸뻾寃궗뿉뒗 씠윭븳 닔삁 쟾뿉 떆뻾븯뿬빞 븯뒗 삁븸삎寃궗 鍮꾩삁湲고빆泥대 寃異쒗븯뿬빞 븯뒗 鍮꾩삁湲고빆泥 꽑蹂꾧궗 諛 援먯감떆뿕씠 룷븿릺뼱 엳떎. 遺遺 삁븸뻾뿉꽌 떎떆븯怨 엳뒗 寃궗쓽 썝由щ뒗 쟻삁援ъ 삁옣 샊 삁泥쓣 씠슜븳 硫댁뿭삁援 쓳吏묐쾿 寃궗씠硫, 떎瑜 吏꾨떒寃궗쓽븰 遺꾩빞쓽 寃궗뿉 鍮꾪븯뿬 옄룞솕媛 媛옣 뒭 遺꾩빞씠湲곕룄 븯떎. 뵲씪꽌 씠윭븳 寃궗뱾쓽 궡遺젙룄愿由щЪ吏덈뱾 꼸由 긽뭹솕릺뼱 엳吏룄 븡쓣肉먮뜑윭 긽뭹솕릺뼱 엳뒗 臾쇱쭏 怨좉씠湲 븣臾몄뿉 씪諛 寃궗떎뿉꽌뒗 씠뱾쓣 援ъ엯븯뿬 궗슜븯湲곕낫떎뒗 遺遺 옄媛젣議곕Ъ吏덉쓣 궗슜븯怨 엳뒗 떎젙씠떎. 씠윭븳 씠쑀濡 삁븸뻾寃궗쓽 쇅遺젙룄愿由 李몄뿬뒗 寃궗쓽 떊猶곕룄瑜 룊媛븷 닔 엳뒗 留ㅼ슦 以묒슂븳 怨쇱젙씠씪怨 븷 닔 엳떎.

븳엫긽寃궗젙룄愿由ы삊쉶뿉꽌뒗 2016뀈遺꽣 깉濡寃 궗뾽 봽濡쒓렇옩쓣 援ъ꽦븯怨 李⑥꽭 쟾궛떆뒪뀥쓣 媛쒕컻븯뿬 李⑥꽭 떊鍮숇룄議곗궗궗뾽쓣 떆뻾븯寃 릺뿀떎. 2015뀈源뚯 떎떆븳 ABO 삁븸삎寃궗, RhD 삁븸삎寃궗, 援먯감떆뿕寃궗, 吏곸젒빆湲濡쒕텋由곌궗, 鍮꾩삁湲고빆泥 꽑蹂꾧궗 諛 빆泥대룞젙寃궗 벑 珥 6媛吏 빆紐⑷낵 異붽濡 떎떆븳 떆踰뷀빆紐⑹씠 룷븿릺뼱 엳뿀떎[1,2]. 洹몃윭굹 2016뀈遺꽣뒗 닔삁쓽븰寃궗뱾씠 떎쓬怨 媛숈씠 4媛쒖쓽 봽濡쒓렇옩쑝濡 굹돇뼱 10媛吏쓽 빆紐⑹쑝濡 떆뻾븯寃 릺뿀떎. (1) 씪諛섏닔삁寃궗: ABO typing (ABO 삁븸삎), RhD typing (RhD 삁븸삎), crossmatching (援먯감떆뿕); (2) 닔삁빆썝寃궗, 듅닔: ABO subtyping (ABO 븘삎 삁븸삎), Rh CcEe antigen testing (Rh CcEe 빆썝寃궗), weak D test (빟 D寃궗); (3) 닔삁빆泥닿궗, 씪諛: antibody screening (鍮꾩삁湲고빆泥 꽑蹂꾧궗), direct antiglobulin test (吏곸젒빆湲濡쒕텋由곌궗); (4) 닔삁빆泥닿궗, 듅닔: antibody identification (鍮꾩삁湲고빆泥 룞젙寃궗), ABO Ab titration (ABO 빆泥 뿭媛寃궗). 삉븳 媛 봽濡쒓렇옩쓽 愿由щ룄 삁븸뻾遺꾧낵뿉꽌 닔삁쓽븰 봽濡쒓렇옩쑝濡 諛붾뚭쾶 릺뿀떎.

씠뿉 옄뱾 2016뀈뿉 4媛쒖쓽 닔삁쓽븰 봽濡쒓렇옩뿉꽌 떎떆븳 10媛吏쓽 寃궗빆紐⑹뿉 븯뿬 2李⑥뿉 嫄몄퀜 떊鍮숇룄議곗궗瑜 떎떆븯怨, 湲곌蹂 寃궗諛⑸쾿뿉 븳 寃곌낵 떎떆븯뜕 썙겕닄 媛쒖턀 궗뾽궡슜쓣 蹂닿퀬븯怨좎옄 븳떎.

옱猷 諛 諛⑸쾿

1. 議곗궗빆紐

議곗궗빆紐⑹ 꽌濡좎뿉꽌 뼵湲됲븳 諛붿 留덉갔媛吏濡 ABO 삁븸삎 RhD 삁븸삎, 援먯감떆뿕, ABO 븘삎 삁븸삎, Rh CcEe 빆썝寃궗, 빟 D寃궗, 鍮꾩삁湲고빆泥 꽑蹂꾧궗, 吏곸젒빆湲濡쒕텋由곌궗, 鍮꾩삁湲고빆泥 룞젙寃궗, ABO 빆泥 뿭媛寃궗쓽 10媛吏 빆紐⑹뿉 븳 떊鍮숇룄議곗궗瑜 떎떆븯떎.

2. 쇅遺떊鍮숇룄 議곗궗臾쇱쭏슜 젣議

寃泥 젣議곕뒗 2016뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽쓣 쐞븳 옄媛젣議곕Ъ吏 媛쒕컻쓽 슜뿭뿰援щ 留≪ 븘二쇰븰援먮퀝썝뿉꽌 떎쓬怨 媛숈씠 젣議고븯떎. 寃泥 젣議곗뿉 궗슜맂 삁븸젣젣뱾 븳쟻떗옄궗 븳留덉쓬 삁븸썝쑝濡쒕꽣 깮紐낆쑄由ъ떖쓽瑜 뱷븳 썑뿉 궗슜븯떎. 옄媛젣議곕맂 紐⑤뱺 寃泥대뒗 寃궗옄 2씤씠 媛곴컖 寃궗븯뿬 寃곌낵 諛 쓳吏 젙룄瑜 솗씤븯떎. 븘二쇰븰援먮퀝썝뿉꽌 젣議곕릺怨 몴떇씠 遺숈뿬吏 쇅遺떊鍮숇룄議곗궗臾쇱쭏뱾 븳엫긽寃궗젙룄愿由ы삊쉶濡 슫諛섎릺뼱 룷옣맂 썑 媛 李몄뿬湲곌쑝濡 諛쒖넚릺뿀떎. 쇅遺떊鍮숇룄議곗궗 寃泥대뒗 1李 5썡 16씪, 2李⑤뒗 10썡 31씪뿉 怨꾩빟 깮諛곕 씠슜븯뿬 媛곴컖 諛쒖넚븯떎. 寃궗寃곌낵뒗 李⑥꽭 떊鍮숇룄議곗궗궗뾽 솃럹씠吏뿉 엯젰븯룄濡 븯떎.

1) 삁援щ쑀븸 젣議

떊鍮숇룄議곗궗 寃궗빆紐(媛 쉶李⑤떦 寃泥 닔)씤 ABO 삁븸삎쓽 삁援ы삎 寃궗(3媛), RhD 삁븸삎(3媛), 援먯감떆뿕슜 쟻삁援 遺쑀븸(1媛), ABO 븘삎 삁븸삎(1媛), Rh CcEe 빆썝寃궗(1媛), 洹몃━怨 빟 D寃궗(1媛)瑜 쐞븳 쟻삁援 遺쑀븸 紐⑹쟻븯怨좎옄 븯뒗 삁븸삎쓣 媛吏 삁븸쓣 삁援щ낫議댁븸씤 EC Stabilizing solution (DiaMed GmbH, Cressier, Switerland)쓣 궗슜븯뿬 3%濡 씗꽍븯떎. ABO 븘삎 삁븸삎怨 빟 D寃궗 寃泥대뒗 룞씪븳 삁븸삎쓣 媛吏 EDTA (ethylenediamine tetraacetic acid) 쑀옒寃궗슜 寃泥대뱾쓣 媛곴컖 샎二쇳븯뿬 궗슜븯怨, 洹 씠쇅뒗 CPDA (citrate phosphate dextrose adenine)-1 삁븸 諛깆뿉꽌 遺꾨━맂 냽異뺤쟻삁援щ 궗슜븯떎[1,2]. 삁븸諛깆쓽 샎二 떆뒗 臾닿퇏遊됲빀湲곕줈 뿰寃고븯뿬 샎빀븳 떎쓬 遺꾩<븯떎.

2) 삁옣슜 寃泥 젣議

ABO 삁泥寃궗슜 삁援ы삎怨 룞씪븳 ABO 삁븸삎, ABO 빆泥 뿭媛寃궗슜 O삎쓽 떊꽑룞寃고삁옣쓣 궗슜븯떎. 삁븸諛깆쓽 샎二 떆뒗 臾닿퇏遊됲빀湲곕줈 뿰寃고븯뿬 샎빀븳 떎쓬 遺꾩<븯떎. 洹몃윭굹 2李⑥쓽 ABO 삁泥寃궗슜 떊꽑룞寃고삁옣 떊 삁泥삎뿉 빐떦븯뒗 빆삁泥쓣 떇뿼닔뿉 씗꽍븯뿬 궗슜븯떎[1,2].

3) 옱議고빀 삁옣 寃泥 젣議

떊鍮숇룄議곗궗 寃궗빆紐(媛 쉶李⑤떦 寃泥 닔)씤 援먯감떆뿕(3媛), 鍮꾩삁湲고빆泥 꽑蹂꾧궗(3媛), 鍮꾩삁湲고빆泥 룞젙寃궗(2媛)뒗 빆삁泥뿉 떊꽑룞寃고삁옣 샊 떇뿼닔瑜 씠슜븯뿬 옱議고빀븯떎. 援먯감떆뿕 뼇꽦 寃泥대뒗 빆湲濡쒕텋由 떒怨꾩뿉꽌留 寃異쒕릺怨 洹 씠쇅쓽 떒怨꾩뿉꽌뒗 寃異쒕릺吏 븡嫄곕굹 빟븯寃 寃異쒕맆 젙룄쓽 빆삁泥쓽 빆泥 뿭媛瑜 씗꽍븯뿬 寃泥대 젣議고븯뒗뜲, 긽뭹솕맂 씤媛꾩쑀옒 떎겢濡좎꽦 빆-D 빆泥(DiaMed GmbH)瑜 援먯감떆뿕슜 쟻삁援 遺쑀븸怨 諛섏쓳떆耳곕떎[1,2]. 빆삁泥 씗꽍 떆 1李⑤뒗 룞씪븳 ABO 삁븸삎쓽 떊꽑룞寃고삁옣, 2李⑤뒗 떇뿼닔뿉 씗꽍븯떎.

鍮꾩삁湲고빆泥 꽑蹂꾧궗슜 뼇꽦 寃泥대줈뒗 1쉶李 븣 빆-K 빆泥댁 빆-E 빆泥, 2쉶李 븣 빆-e 빆泥대 諛쒖넚븯怨, 룞젙슜 뼇꽦 寃泥대줈뒗 1쉶李 빆-Fya 빆泥댁 빆-N 빆泥, 2쉶李 븣 빆-K 빆泥댁 빆-e 빆泥대 諛쒖넚븯떎. 寃泥대뒗 빆삁泥 떆빟쓣 媛곴컖 씗꽍븯뿬 궗슜븯뒗뜲 궗슜맂 빆삁泥 떆빟쓽 醫낅쪟뒗 媛곴컖 떎겢濡좎꽦빆-Fya 빆泥(CE Diagnostika GmbH, Eschelbronn, Germany), 떒겢濡좎꽦 빆-N 빆泥(CE Diagnostika GmbH), 떎겢濡좎꽦 빆-K 빆泥(CE Diagnostika GmbH), 떒겢濡좎꽦 빆-e빆泥(Diagast, Parc Eurasant챕, France)떎. 씗꽍 떆뒗 援먯감떆뿕슜 옱議고빀 삁옣 寃泥 젣議곗 留덉갔媛吏濡 1李⑤뒗 룞씪븳 ABO 삁븸삎쓽 떊꽑룞寃고삁옣, 2李⑤뒗 떇뿼닔뿉 씗꽍븯떎. 鍮꾩삁湲고빆泥 꽑蹂꾧궗슜 쓬꽦 寃泥대뒗 떊꽑룞寃고삁옣뿉 1李⑤뒗 鍮꾩삁湲고빆泥 쓬꽦씤 떊꽑룞寃고삁옣쓣 泥④븯怨, 2李⑤뒗 떇뿼닔留뚯쓣 궗슜븯떎[1,2].

4) 吏곸젒빆湲濡쒕텋由곌궗슜 삁援 젣議

뼇꽦 吏곸젒빆湲濡쒕텋由곌궗슜 삁援щ뒗 긽뭹솕맂 媛먯옉삁援 immunoglobulin G (IgG) Coated Cell (Mirr Scitech, Seoul, Korea)瑜 씠슜븯怨, 쓬꽦 吏곸젒빆湲濡쒕텋由곌궗슜 삁援щ뒗 吏곸젒빆湲濡쒕텋由 寃궗寃곌낵 쓬꽦씤 쟻삁援щ 삁援щ낫議댁븸씤 EC Stabilizing solution (DiaMed GmbH)뿉 3% 씗꽍븯뿬 씠슜븯떎.

3. 寃곌낵 뙋젙 諛 遺꾩꽍 寃泥

젙떟瑜 궛젙 떆 룞씪 寃궗醫낅ぉ뿉 븯뿬 씪遺 寃泥댁뿉 븯뿬 떟蹂쓣 븯吏 븡嫄곕굹 紐⑤뱺 寃泥댁뿉 븯뿬 씪遺留 떟蹂븳 寃쎌슦뒗(삁, 쓳吏묎컯룄留 몴떆븯怨 理쒖쥌 뙋젙쓣 븯吏 븡 寃쎌슦) Code 712濡 媛꾩<븯怨 씠뒗 삤떟쑝濡 룊媛븯떎. 삉븳 援먯감떆뿕씠굹 빐떦寃궗瑜 떆뻾븯湲곗뿉 쟻젅븯吏 븡 뒳씪씠뱶踰뺤 遺꾩꽍뿉꽌 젣쇅븯떎. 援먯감떆뿕쓽 寃쎌슦 쓬꽦쑝濡 쟻빀 뙋젙쓣 븳 寃泥댁뿉 빐꽌뒗 쓳吏묒씠 뾾떎怨 蹂닿퀬븳 寃쎌슦留 젙떟쑝濡 媛꾩<븯떎. Rh CcEe 빆썝寃궗 吏곸젒빆湲濡쒕텋由곌궗쓽 寃쎌슦 1+ 씠긽쓣 뼇꽦쑝濡 媛꾩<븯뿬 뼇꽦 寃泥댁쓽 젙떟瑜좎쓣 궛젙븯떎. ABO 빆泥 뿭媛寃궗쓽 뿀슜踰붿쐞뒗 李몄뿬湲곌씠 10湲곌 씠긽씤 寃궗踰뺤뿉 븯뿬 理쒕퉰룄 긽븯 븳 떒怨꾩뵫 異붽븯怨 씠 踰붿쐞뿉 냽븯뒗 李몄뿬湲곌씠 80%瑜 꽆吏 븡쓣 寃쎌슦뿉뒗 理쒕퉰룄 긽븯 떒怨 洹쇱쿂쓽 鍮덈룄닔媛 留롮 떒怨꾨 뜑 異붽븯뿬 寃곗젙븯떎.

4. 썙겕닄 媛쒖턀

삁븸뻾 떎湲 썙겕닄 삁븸뻾遺꾧낵 떒룆쑝濡 二쇨븯뿬 珥 1쉶쓽 썙겕닄쓣 媛쒖턀븯뒗뜲, 썙겕닄뿉 븳 怨듭뒗 媛쒖턀 쟾뿉 솃럹씠吏쓽 寃뚯떆뙋怨 臾몄옄닔떊 벑쓣 씠슜븯떎.

寃곌낵

1. 씪諛섏닔삁寃궗

1) ABO RhD 삁븸삎

ABO 삁븸삎寃궗뒗 2李⑥뿉 嫄몄퀜 珥 6媛쒖쓽 寃泥대줈 떎떆븯怨, 젙떟瑜좎 98.9%-99.7%瑜 굹깉떎(Table 1). 1李(2李)쓽 삁援ы삎 寃궗踰뺤 뒳씪씠뱶踰 49.8% (48.0%), 떆뿕愿踰 42.8% (46.4%) 닚씠뿀쑝硫, 1李(2李)쓽 삁泥삎寃궗踰뺤 떆뿕愿踰뺤씠 85.0% (87.5%), 뒳씪씠뱶踰 9.2% (8.2%) 닚쑝濡 굹궗떎. RhD 삁븸삎寃궗룄 2李⑥뿉 嫄몄퀜 珥 6媛쒖쓽 寃泥대줈 떎떆븯怨, 젙떟瑜좎 98.6%-99.8%瑜 굹깉떎(Table 2). 1李(2李)쓽 寃궗踰뺤 1李⑥뿉꽌뒗 떆뿕愿踰뺤씠 51.1% (55.3%), 뒳씪씠뱶踰 40.3% (38.7%) 닚씠뿀떎.

Table 1 . Number (%) of participants in proficiency tests for ABO blood grouping in 2016.

TrialSpecimenTotalABABODisNAIntended response
1BB-16-01+BB-16-04641 (100.0)634 (98.9)2 (0.3)4 (0.6)1 (0.2)A
BB-16-02+BB-16-05641 (100.0)1 (0.2)639 (99.6)1 (0.2)O
BB-16-03+BB-16-06641 (100.0)1 (0.2)635 (99.1)2 (0.3)2 (0.3)1 (0.2)AB
2BB-16-07+BB-16-10613 (100.0)1 (0.2)619 (99.5)2 (0.3)B
BB-16-08+BB-16-11613 (100.0)1 (0.2)621 (99.7)1 (0.2)O
BB-16-09+BB-16-12613 (100.0)618 (99.2)1 (0.2)3 (0.4)1 (0.2)A

Values are presented as number (%), unless otherwise stated..

Abbreviations: Dis, discrepancy between cell typing and serum typing; NA, not available..


Table 2 . Number (%) of participants in proficiency tests for RhD typing in 2016.

TrialSpecimenTotalPositiveVariantNegativeNAIntended response
1BB-16-01614 (100.0)5 (0.8)2 (0.3)605 (98.6)2 (0.3)Negative
BB-16-02614 (100.0)606 (98.7)8 (1.3)0Positive
BB-16-03614 (100.0)611 (99.5)1 (0.2)2 (0.3)0Positive
2BB-16-07599 (100.0)598 (99.8)1 (0.2)Positive
BB-16-08599 (100.0)598 (99.8)1 (0.2)Positive
BB-16-09599 (100.0)2 (0.3)3 (0.5)594 (99.2)Negative

Values are presented as number (%), unless otherwise stated..

Abbreviation: NA, not available..


2) 援먯감떆뿕

援먯감떆뿕寃궗뒗 2李⑥뿉 嫄몄퀜 珥 6媛쒖쓽 寃泥닿 궗슜릺뿀쑝硫, 쟻빀 寃泥대뒗 96.7%-98.1%, 遺쟻빀 寃泥대뒗 90.1%-94.1%쓽 援먯감떆뿕 뙋젙 젙떟瑜좎쓣 蹂댁뿬 95.8%쓽 룊洹 젙떟瑜좎쓣 蹂댁떎. 媛 떒怨꾨퀎 젙떟瑜좎쓣 遺꾩꽍븳 寃곌낵, 쟻빀 寃泥닿 96.1%-100.0%씠怨, 遺쟻빀 寃泥닿 66.7%-100.0%濡 遺쟻빀 寃泥댁뿉꽌 삤떟瑜좎씠 뜑 넂븯떎. 젙떟瑜좎 寃궗湲곌씠 10媛 誘몃쭔씤 寃궗踰뺤쓣 젣쇅븯怨좊뒗 誘몄꽭썝二쇱쓳吏묐쾿씠 99.1%濡 媛옣 넂븯怨 빆湲濡쒕텋由 떒怨꾩쓽 떆뿕愿踰뺤 95.5%떎(Table 3). 寃궗踰뺤 理쒖쥌 뙋젙쓣 떎떆븳 湲곌 以 以묐났 떆뻾쓣 룷븿븯뿬 떆뿕愿踰뺤씠 1李(2李)媛 媛곴컖 85.6% (87.0%)濡 媛옣 留롮씠 궗슜븯뒗 諛⑸쾿쑝濡 굹궗쑝硫, 誘몄꽭썝二쇱쓳吏묐쾿 27.4% (28.6%)瑜 李⑥븯떎.

Table 3 . Number and % of participants in proficiency tests for blood crossmatching.

RBC suspensionBB-16-04BB-16-08Mean of correct answer (%)



SpecimenBB-16-04BB-16-05BB-16-06BB-16-10BB-16-11BB-16-12







ResultsAUAAUAAUAAUAAUAAUA







Intended responseIncompatibleCompatibleCompatibleCompatibleCompatibleIncompatible
Tube-saline457 (97.6)11 (2.4)455 (97.2)13 (2.8)454 (97.0)14 (3.0)451 (98.7)6 (1.3)450 (98.5)7 (1.5)450 (98.5)7 (1.5)97.9
Tube-37째C albumin429 (98.2)8 (1.8)420 (96.1)17 (3.9)422 (96.8)14 (3.2)414 (97.4)11 (2.6)417 (98.1)8 (1.9)422 (99.3)3 (0.7)97.6
Tube-AHG377 (87.7)53 (12.3)416 (97.9)9 (2.1)420 (97.9)9 (2.1)405 (97.4)11 (2.6)407 (97.8)9 (2.2)393 (94.5)23 (5.5)95.5
Tube-LISS8 (80.0)2 (20.0)10 (100.0)10 (100.0)7 (100.0)7 (100.0)6 (85.7)1 (14.3)94.3
Tube-37째C LISS9 (100.0)9 (100.0)9 (100.0)9 (100.0)9 (100.0)6 (66.7)3 (33.3)94.4
CAT147 (98.0)3 (2.0)150 (100.0)150 (100.0)149 (99.3)1 (0.7)149 (99.3)1 (0.7)147 (98.0)3 (2.0)99.1
LMP01 (100.0)1 (100.0)1 (100.0)1 (100.0)1 (100.0)1 (100.0)83.3
Other1 (100.0)1 (100.0)1 (100.0)1 (100.0)1 (100.0)1 (100.0)100.0
Final decision493 (90.1)54 (9.9)529 (96.7)18 (3.3)535 (97.8)12 (2.2)514 (97.9)11 (2.1)515 (98.1)10 (1.9)494 (94.1)31 (5.9)95.8

Values are presented as number (%), unless otherwise stated..

Abbreviations: RBC, red blood cell suspensions; A, acceptable response; UA, unacceptable response; AHG, anti-human immunogloblulin; LISS, low ionic salt solution; CAT, column agglutination test; LMP, liquid microplate..


2. 닔삁빆썝寃궗

1) ABO 븘삎 삁븸삎

1李 寃泥대뒗 A2Bw삎쑝濡 95.2% (40/42)쓽 젙떟瑜좎쓣 蹂댁뒗뜲 빆-B 떆빟怨쇱쓽 諛섏쓳뿉꽌 2+ 씠븯 샎빀떆빞瑜 蹂닿퀬븳 湲곌 87.1%, 빆-H 떆빟怨쇱쓽 諛섏쓳뿉꽌 3+ 씠긽쓣 蹂닿퀬븳 湲곌 60.7%떎 2李 寃泥대뒗 Bw삎쑝濡 92.7% (38/41)뿉꽌 젙떟瑜좎쓣 蹂댁뒗뜲 빆-B 떆빟怨쇱쓽 諛섏쓳뿉꽌 2+ 씠븯 샎빀떆빞瑜 蹂닿퀬븳 湲곌 87.8%, 빆-H 떆빟怨쇱쓽 諛섏쓳뿉꽌 3+ 씠긽쓣 蹂닿퀬븳 湲곌 75.0%떎(Table 4).

Table 4 . Number (%) of participants in proficiency tests for ABO subtyping.

Trial (specimen)RBC agglutinationAnti-seraABO subgroup

Anti-AAnti-BAnti-A1Anti-H
1 (BGS-16-01)긖otal42424228A21.0 (2.4)
긏egative1 (2.4)41 (97.6)A1Bw1.0 (2.4)
2 (4.8)A2Bw*40 (95.2)
1+10 (23.8)1 (2.4)
2+15 (35.7)11 (39.3)
3+5 (11.9)3 (7.1)11 (39.3)
4+37 (88.1)2 (4.8)6 (21.4)
긎F9 (21.4)
2 (BGS-16-02)긖otal41413724A21 (2.4)
긏egative41 (100.0)37 (100.0)B2 (4.9)
1 (2.4)Bw*38 (92.7)*
1+4 (9.8)1 (4.2)
2+15 (36.6)5 (20.8)
3+5 (12.2)4 (16.7)
4+14 (58.3)
긎F16 (39.0)

Values are presented as number (%), unless otherwise stated..

Abbreviations: RBC, red blood cell suspensions; MF, mixed field agglutination..

*Intended responses for ABO subgrouping.


2) Rh CcEe 빆썝寃궗

Rh CcEe 빆썝寃궗뒗 45媛(E 빆썝 46媛) 湲곌뿉꽌 李몄뿬븯떎. 1李 寃泥대뒗 CcEe빆썝씠 뼇꽦쑝濡 紐⑤뱺 湲곌뿉꽌100% 젙떟瑜좎쓣 蹂댁떎. Ce빆썝留 뼇꽦씤 2李 寃泥대뒗 E빆썝 2.2% 1+ c 빆썝 2.2% trace瑜 蹂댁씤 寃쎌슦瑜 젣쇅븯怨좊뒗 紐⑤몢 젙떟쓣 굹궡뿀떎(Table 5).

Table 5 . Number (%) of participants in proficiency tests for Rh CcEe antigen typing.

Trial (specimen)RBC agglutinationAnti-sera

CEce
1 (BGS-16-02)긖otal45464545
긏egative
1+1 (2.2)1 (2.2)
2+7 (15.6)6 (13.0)2 (4.4)3 (6.7)
3+14 (31.1)11 (23.9)15 (33.3)17 (37.8)
4+24 (53.3)29 (63.0)27 (60.0)24 (53.3)
2 (BGS-16-05)긖otal45464545
긏egative45 (97.8)44 (97.8)
1 (2.2)*
1+1 (2.2)1 (2.2)*1 (2.2)
2+3 (6.7)4 (8.9)
3+13 (28.9)14 (31.1)
4+28 (62.2)26 (57.8)

Values are presented as number (%), unless otherwise stated..

Abbreviation: RBC, red blood cell suspensions..

*Unacceptable responses for Rh CcEe antigen test.


3) 빟 D寃궗

빟 D寃궗뒗 1李 70.8%, 2李⑤뒗 73.6%뿉꽌 쓽룄븳 蹂씠삎 D濡 蹂닿퀬븯쑝굹, 25.8% 23.1%뿉꽌뒗 RhD 삁븸삎寃궗뿉꽌뒗 쓬꽦씠怨 빟 D寃궗뿉꽌 뼇꽦씠뿀쓬뿉룄 遺덇뎄븯怨 RhD 뼇꽦쑝濡 蹂닿퀬븯떎(Table 6).

Table 6 . Number (%) of participants in proficiency tests for weak D test.

꺿꺿긖rial (specimen)1 (BGS-16-03)2 (BGS-16-06)


RhDWeak DRhDWeak D
Total90909191
Negative83 (92.2)3 (3.3)86 (94.5)3 (3.3)
3 (3.3)5 (5.5)
1+1 (1.1)2 (2.2)6 (6.6)
2+2 (2.2)22 (24.4)25 (27.5)
3+1 (1.1)44 (48.9)42 (46.2)
4+19 (21.1)15 (16.5)
D positive23 (25.8)21 (23.1)
D variant*63 (70.8)67 (73.6)
D negative3 (3.4)3 (3.3)

Values are presented as number (%), unless otherwise stated..

*Intended responses for weak D testing.


3. 씪諛 닔삁빆泥닿궗

1) 鍮꾩삁湲고빆泥 꽑蹂꾧궗

鍮꾩삁湲고빆泥 꽑蹂꾧궗뒗 1李⑥ 2李⑥쓽 寃쎌슦 紐⑤몢 2媛쒖쓽 뼇꽦 寃泥댁 1媛쒖쓽 쓬꽦 寃泥대 諛쒖넚븯뒗뜲, 2李⑤븣 諛쒖넚맂 2媛쒖쓽 뼇꽦 寃泥댁쓽 빆泥 뿭媛媛 湲됯꺽엳 븯릺뼱 떎젣 룊媛湲곌뿉꽌 寃궗 떦떆 寃異쒕릺吏 븡쓬씠 솗씤릺뼱 룊媛뿉꽌 씠뱾쓣 젣쇅븯떎. 씠 寃泥대뱾쓣 젣쇅븳 쓬꽦 寃泥댁쓽 젙떟瑜좎 99.6%-100.0%쑝굹 뼇꽦 寃泥댁쓽 젙떟瑜좎 96.6%-100.0%떎(Table 7). 1李(2李)쓽 빆泥댁꽑蹂 寃궗踰뺤 誘몄꽭썝二쇱쓳吏묐쾿 90.6% (91.8%), 떆뿕愿踰 4.2% (4.1%)瑜 李⑥븯떎.

Table 7 . Number (%) of participants in proficiency tests for antibody screening.

TrialSpecimenNumberResultsIntended response

PositiveNegative
1BBG-16-01266266 (100.0)긑ositive
BBG-16-02266257 (96.6)9 (3.4)긑ositive
BBG-16-032661 (0.4)265 (99.6)긏egative
2BBG-16-07267267 (100.0)긏egative
BBG-16-082676 (2.2)261 (97.8)긑ositive*
BBG-16-0926739 (14.6)228 (85.4)긑ositive*

Values are presented as number (%), unless otherwise stated..

*Not evaluated due to the poor quality of specimens.


2) 吏곸젒빆湲濡쒕텋由곌궗

吏곸젒빆湲濡쒕텋由곌궗뒗 2李⑥뿉 嫄몄퀜 珥 6媛쒖쓽 寃泥닿 궗슜릺뿀뒗뜲, 빆湲濡쒕텋由 떆빟뿉 뵲瑜 젙떟瑜좎 떎듅씠꽦 92.2%-99.6%, IgG 떒듅씠꽦 84.1%-100.0%, 洹몃━怨 C3d 떒듅씠꽦 80.0%-100.0%떎. 뼇꽦(쓬꽦) 寃泥댁쓽 젙떟瑜좎 떎듅씠꽦 92.2%-97.2% (93.5%-99.6%), 떒듅씠꽦 IgG 85.5%-95.5% (84.1%-100.0%), 洹몃━怨 떒듅씠꽦 C3d 80.0%-89.6% (85.7%-100.0%)濡 쓬꽦 寃泥댁쓽 젙떟瑜좎뿉 鍮꾪븯뿬 궙븯떎(Table 8). 떎듅씠꽦 빆湲濡쒕텋由 떆빟쓣 씠슜븳 寃궗踰뺤 誘몄꽭썝二쇱쓳吏묐쾿씠 1李(2李)媛 媛곴컖 62.3% (64.4%)뵫쑝濡 媛옣 留롮씠 궗슜븯쑝硫 떆뿕愿踰뺤씠 33.2% (34.4%)쑝濡 굹궗떎.

Table 8 . Number (%) of participants in proficiency tests for the direct antiglobulin test.

TrialSpecimenAntiglobulin reagentsNumberResultsIntended response

PositiveNegativeOther
1BBG-16-04Polyspecific2475 (2.1)231 (93.5)11 (4.4)긏egative
Anti-IgG6959 (85.5)10 (14.5)긏egative
Anti-C3d7060 (85.7)10 (14.3)긏egative
BBG-16-05Polyspecific2477 (2.9)234 (94.7)6 (2.4)긏egative
Anti-IgG691 (1.4)58 (84.1)10 (14.5)긏egative
Anti-C3d7060 (85.7)10 (14.3)긏egative
BBG-16-06Polyspecific247228 (92.2)8 (3.2)11 (4.6)긑ositive
Anti-IgG6959 (85.5)2 (2.9)8 (11.6)긑ositive
Anti-C3d7056 (80.0)5 (7.1)9 (12.9)긑ositive
2BBG-16-10Polyspecific2501 (0.4)249 (99.6)긏egative
Anti-IgG6767 (100.0)긏egative
Anti-C3d6767 (100.0)긏egative
BBG-16-11Polyspecific250243 (97.2)7 (2.8)긑ositive
Anti-IgG6764 (95.5)3 (4.5)긑ositive
Anti-C3d677 (10.4)60 (89.6)긑ositive
BBG-16-12Polyspecific2502 (0.8)248 (99.2)긏egative
Anti-IgG6767 (100.0)긏egative
Anti-C3d6767 (100.0)긏egative

Values are presented as number (%), unless otherwise stated..

Abbreviation: IgG, immunoglobulin G..


4. 듅닔 닔삁빆泥닿궗

1) 鍮꾩삁湲고빆泥 룞젙寃궗

빆泥 룞젙寃궗쓽 젙떟瑜좎 anti-N怨 anti-Fya뒗 媛곴컖 96.7%, anti-K뒗 99.1%쑝굹, 2李⑤븣 諛쒖넚맂 寃泥 以 anti-e 寃泥댁쓽 빆泥 뿭媛媛 湲됯꺽엳 븯릺뼱 떎젣 룊媛湲곌뿉꽌 寃궗 떦떆 寃異쒕릺吏 븡쓬뿉 솗씤릺뼱 룊媛뿉꽌 씠瑜 젣쇅븯떎(Table 9). 듅엳 1李 떆 紐⑤뱺 寃泥댁뿉꽌 寃異쒕맂 anti-N怨 anti-Fya 빆泥대 븯굹쓽 寃泥닿껐怨쇱뿉 anti-N+anti-Fya 엯젰븳 湲곌쓽 寃곌낵뒗 삤떟쑝濡 泥섎━븯떎.

Table 9 . Number (%) of participants in proficiency tests for antibody identification.

TrialSpecimenNumberIntended response꺿꺿꺿꺿긐ther responses (no. of participants)

AntibodyNo. (%)
1BBS-16-01118Anti-Fya114 (96.7)Anti-Fya+anti-N (2), anti-E (1)
BBS-16-02118Anti-N114 (96.7)Anti-K (1), Others (1), None (2)
2BBS-16-04*117Anti-e10 (8.5)Anti-C+e (11), anti-C (1), anti-e (1), anti-Jk짧 (1), anti-P1 (1), Others (7), None (86)
BBS-16-05117Anti-K116 (99.1)Anti-E (1, 0.9%)

*Not evaluated due to the poor quality of specimens.


2) ABO 빆泥 뿭媛寃궗

媛 諛⑸쾿蹂 ABO 빆泥 뿭媛寃궗寃곌낵뒗 Table 10怨 媛숈쑝硫 뿀슜踰붿쐞뒗 援듭 湲뵪濡 몴떆븯떎. Anti-A쓽 寃쎌슦 뿀슜踰붿쐞뿉 뱶뒗 李몄뿬湲곌 鍮꾩쑉 1李⑥ 2李⑤뒗 媛곴컖 떆뿕愿 利됱떆썝移⑤쾿 紐⑤몢 82.9% (34/41) 85.7% (36/42), 떆뿕愿 떎삩諛곗뼇踰 93.3% (14/15) 82.4% (14/17), 떆뿕愿 빆湲濡쒕텋由곕쾿 94.4% (17/18)怨 83.3% (15/18), 誘몄꽭썝二쇱쓳吏 빆湲濡쒕텋由곕쾿 100.0% (21/21)怨 95.8% (23/24)濡 媛옣 넂븯떎. Anti-B쓽 寃쎌슦 뿀슜踰붿쐞뿉 뱶뒗 李몄뿬湲곌 鍮꾩쑉 1李⑥ 2李⑤뒗 媛곴컖 떆뿕愿 利됱떆썝移⑤쾿 紐⑤몢 95.1% (39/41)怨 81.0% (34/42), 떆뿕愿 떎삩諛곗뼇踰 100.0% (15/15)怨 94.1% (16/17)濡 媛옣 넂븯怨, 떆뿕愿 빆湲濡쒕텋由곕쾿 94.4% (17/18)怨 83.3% (15/18), 誘몄꽭썝二쇱쓳吏 빆湲濡쒕텋由곕쾿 95.2% (20/21)怨 95.8% (23/24) 떎. IgM 痢≪젙쓣 쐞븯뿬 2012뀈 몴以븞쑝濡 젣떆맂 떆뿕愿 떎삩諛곗뼇踰뺤뿉 鍮꾪븯뿬 떆뿕愿 利됱떆썝移⑤쾿쓣 궗슜븯뒗 湲곌씠 뜑 留롮븯怨, IgG 痢≪젙쓣 쐞빐꽌뒗 誘몄꽭썝二쇱쓳吏묐쾿, 빆湲濡쒕텋由곕쾿쓣 궗슜븯뒗 湲곌씠 뜑 留롮븯떎.

Table 10 . Number of participants in proficiency tests for ABO antibody titration.

꺿꺿꺿꺿긖echnique (% of allowable range)*TrialNumberTiter

248163264128256512
Anti-A
긖ube-IS (82.9)141410177111
긖ube-RT (93.3)152121
긖ube-AHG (94.4)1812132
긖ube-AHG, DTT651
귽AT-RT7322
귽AT-AHG (100.0)213882
귽AT-AHG, DTT41111
긐thers211
긖ube-IS (85.7)2421391982
긖ube-RT (82.4)173491
긖ube-AHG (83.3)181296
긖ube-AHG, DTT5131
귽AT-RT7412
귽AT-AHG (95.8)24110751
귽AT-AHG, DTT541
Anti-B
긖ube-IS (95.1)14151218411
긖ube-RT (100.0)151662
긖ube-AHG (94.4)1813113
긖ube-AHG, DTT6213
귽AT-RT7412
귽AT-AHG (95.2)2171031
귽AT-AHG, DTT4112
긐thers11
긖ube-IS (81.0)24216111581
긖ube-RT (94.1)173581
긖ube-AHG (83.3)18121104
긖ube-AHG, DTT523
귽AT-RT743
귽AT-AHG (95.8)24121074
귽AT-AHG, DTT5131

Bold characters express the allowable range for ABO Ab titers according to the technique..

Abbreviations: IS, immediate spin; RT, room temperature incubation; AHG, indirect anti-human globulin test; DTT, treatment with dithiothreitol; CAT, column agglutination technology..

*Percentage of participants within the allowable range.


5. 썙겕닄 媛쒖턀

닔삁 쟾 寃궗 떎湲 썙겕닄쓣 2016뀈 8썡 26씪(湲) 삤쟾 9떆遺꽣 17떆源뚯 븘二쇰븰援 쓽怨쇰븰 넚옱愿븰깮떎뒿떎뿉꽌 1쉶留 媛쒖턀븯떎. 궡슜 ABO 븘삎, RhD 蹂씠삎 寃泥닿궗 寃異쒕쾿, 鍮꾩삁湲고빆泥 寃異쒖썝由, 鍮꾩삁湲고빆泥 꽑蹂꾧낵 룞젙뿉 븯뿬 떎떆븯떎. 삤쟾뿉뒗 씠濡좉컯쓽瑜 떎떆븯뒗뜲 68紐낆씠 李몄꽍븯怨, 삤썑뿉뒗 떎뒿씠 씠猷⑥뼱議뚯쑝硫 50紐낆씠 李몄꽍븯떎.

怨좎같

씪諛섏닔삁寃궗뿉 룷븿맂 ABO RhD 삁븸삎, 援먯감떆뿕怨 ABO 빆泥 뿭媛寃궗뒗 옉뀈뿉 鍮꾪븯뿬 李몄뿬湲곌 닔뒗 利앷븯쑝굹 굹癒몄 寃궗醫낅ぉ뱾쓽 李몄뿬븯뒗 湲곌 닔뒗 媛먯냼븯떎. 씠윭븳 쁽긽 湲곗〈뿉 寃궗醫낅ぉ씠 4媛쒖쓽 봽濡쒓렇옩쑝濡 굹돇硫댁꽌 媛 봽濡쒓렇옩留덈떎 蹂꾨룄쓽 媛寃⑹씠 梨낆젙릺뿀湲 븣臾몄뿉 湲곗〈뿉 떎瑜 寃궗醫낅ぉ뿉룄 李몄뿬븯뜕 湲곌뱾 以 씪遺媛 씪諛섏닔삁寃궗瑜 젣쇅븳 굹癒몄 寃궗빆紐⑸뱾쓣 떊泥븯吏 븡븯湲 븣臾몄쑝濡 빐꽍맂떎. 듅엳 ABO RhD 삁븸삎쓽 寃쎌슦 쟾뀈룄 李몄뿬湲곌 룊洹 543湲곌뿉꽌 2016뀈룄뿉 627湲곌쑝濡 留ㅼ슦 利앷븯떎.

ABO RhD 삁븸삎 젙떟瑜좎 쟾뀈룄뿉 鍮꾪븯뿬 빟媛 븯릺뿀뒗뜲, 씠뒗 떊洹쒓린愿쓽 利앷 1李⑥쓽 寃쎌슦 씪遺 湲곌뿉꽌 쟻삁援 遺쑀븸쓽 슜삁쓣 샇냼븯湲 븣臾몄뿉 삁븸삎寃궗뿉 씪遺 쁺뼢쓣 二쇱뿀쓣 媛뒫꽦룄 엳떎. 삉븳 ABO 삁븸삎쓽 寃쎌슦 2016뀈遺꽣 삁援ы삎怨 삁泥삎쓽 삁援ъ쓳吏묒쓣 紐⑤몢 엯젰븯룄濡 븯湲 븣臾몄뿉 씠뿉 씡닕吏 븡븘 理쒖쥌 삁븸삎 뙋젙쓣 젣濡 븯吏 紐삵븳 湲곌룄 룷븿릺뿀湲 븣臾몄씤 寃껊룄 셿쟾엳 諛곗젣븷 닔 뾾쓣 寃껋쑝濡 蹂댁씤떎. 洹몃윭굹 씪遺 湲곌뿉꽌뒗 ABO 삁븸삎쓽 寃쎌슦 븘吏곷룄 삁援ы삎寃궗留 떎떆븯怨 엳뿀뒗뜲(옄猷 젣떆븯吏 븡쓬), 젙솗븳 삁븸삎 뙋젙쓣 쐞빐꽌뒗 삁泥삎寃궗瑜 諛섎뱶떆 떆뻾븯뿬빞 븯誘濡 뼢썑뿉뒗 삁援ы삎怨 삁泥삎 紐⑤몢 엯젰븯뿬빞 理쒖쥌 삁븸삎 뙋젙쓣 븷 닔 엳룄濡 솉蹂댄븯怨 엯젰봽濡쒓렇옩쓣 蹂寃쏀븷 븘슂媛 엳寃좊떎. 삉븳 理쒓렐 寃궗떎쓽 삁븸삎寃궗뿉 옄룞솕 옣鍮꾩쓽 궗슜씠 利앷븯怨 엳뒗 異붿꽭씠誘濡 쁽옱 諛쒖넚릺뒗 寃泥대뒗 옄룞솕 옣鍮꾩뿉 궗슜븷 닔 뾾뒗 삁옣怨 쟻삁援 遺쑀븸씠誘濡 쟾삁쓽 삎깭濡 쟾솚븯뒗 寃껋씠 諛붾엺吏곹븯寃좊떎.

援먯감떆뿕쓽 룊洹 젙떟瑜좎 95.8%濡 寃궗떒怨꾩 寃궗踰뺤뿉 뵲씪 떎瑜 젙떟瑜좎쓣 蹂댁떎. 援먯감떆뿕 뼇꽦 寃泥대뒗 빆湲濡쒕텋由 떒怨꾩뿉꽌留 寃異쒕릺룄濡 쓽룄릺뿀쑝굹, 빆湲濡쒕텋由 떒怨꾧 룷븿릺吏 븡 떇뿼닔 떒怨꾩 씠삩媛뺣룄떇뿼닔 떒怨꾩뿉꽌룄 寃異쒗븳 湲곌뱾씠 엳쑝誘濡 씠 湲곌뱾씠 誘쇨컧븯寃 寃異쒗븯떎湲곕낫떎뒗 삤엳젮 쐞뼇꽦 뙋젙 媛뒫꽦怨 빆湲濡쒕텋由 떒怨꾩쓽 異붽뿉 븳 援먯쑁씠 씠윭븳 湲곌뱾뿉꽌 븘슂븷 寃껋쑝濡 뿬寃⑥죱떎.

A2Bw삎 寃泥댁뿉 븯뿬 빆-B 떆빟怨쇱쓽 諛섏쓳씠 3+ 씠긽씤 湲곌씠 5湲곌씠굹 릺뒗뜲 씠뱾 湲곌 紐⑤몢 젙긽 B삎쑝濡 媛꾩<븳 湲곌씠 뾾뿀쑝硫, 삉븳 Bw삎 寃泥댁쓽 寃쎌슦 빆-B 떆빟뿉 3+濡 蹂닿퀬븳 湲곌 以 2湲곌 젙긽 B삎쑝濡 蹂닿퀬븯떎. 뵲씪꽌 ABO 븘삎쓣 젙솗엳 뙋젙븯湲 쐞빐꽌 씠뱾 湲곌뿉 븳 삁援 쓳吏 뙋젙湲곗씠굹 寃궗踰 怨쇱젙뿉 븳 寃넗媛 븘슂븷 寃껋쑝濡 뿬寃⑥죱떎. 1李⑥ 2李 寃泥댁뿉 븯뿬 빆-H 떆빟쓽 諛섏쓳씠 2+ 씠븯瑜 蹂댁씤 寃쎌슦媛 媛곴컖 37.9% 25.0%씠誘濡 쟾뀈룄 留덉갔媛吏濡 빆-H 떆빟씠 빆-A 떆빟뿉 鍮꾪븯뿬 삱諛붾Ⅸ 떆빟궗슜踰뺤뿉 븳 援먯쑁씠 븘슂븳 寃껋쑝濡 蹂댁씤떎. 빆-H 떆빟 빆-A 떆빟뿉 鍮꾪븯뿬 궗슜湲곌씠 쟻뿀뒗뜲, 씠뒗 2014뀈 2015뀈 蹂닿퀬꽌룄뿉 吏쟻븯벏씠[1,2] 빆-H 떆빟뿉 븳 떇뭹쓽빟뭹븞쟾泥 뿀媛瑜 뱷븳 援궡 뾽泥닿 뾾뒗 떎젙씠湲 븣臾몄씠떎. 빆-H 떆빟 ABO 븘삎쓣 吏꾨떒븯뿬 솚옄뿉寃 삱諛붾Ⅸ 삁븸삎쓽 삁븸쓣 닔삁븯뒗뜲 븘닔쟻씤 떆빟씠誘濡, 솚옄뱾쓽 븞쟾쓣 쐞븯뿬 씠윭븳 씗洹 떆빟뱾쓽 뿀媛젣룄 媛쒖꽑뿉 븳 삊쉶굹 쑀愿븰쉶쓽 쟻洹뱀쟻씤 솉蹂댁 슂援ш 븘슂븷 寃껋쑝濡 뿬寃⑥죱떎.

2李 Rh CcEe 빆썝寃궗쓽 寃泥대뒗 CDe삎씤뜲 븳 湲곌뿉꽌 빆-c뿉 븯뿬 trace濡 蹂닿퀬븯뿬 씠瑜 빆썝 뼇꽦 뿬遺瑜 寃곗젙븯湲곌 뼱젮썱떎. 蹂 궗뾽뿉꽌뒗 Rh CcEe 빆썝寃궗뿉 븯뿬 誘멸뎅蹂묐━삊쉶뿉꽌 二쇨븯뒗 College of American Pathologists 봽濡쒓렇옩怨 留덉갔媛吏濡 媛 빆썝쓽 삁援 쓳吏 젙룄留 엯젰븯룄濡 릺뼱엳쑝굹 씠 寃궗쓽 理쒖쥌 寃곌낵 삎떇 씠윭븳 빆삁泥쓽 寃곌낵瑜 諛뷀깢쑝濡 빆썝삎쓣 寃곗젙븯뒗 寃껋쑝濡 뼢썑뿉뒗 Rh CcEe쓽 빆썝삎쓣 엯젰븯뒗 移몃룄 異붽媛 븘슂븷 寃껋쑝濡 깮媛곷릺뿀떎.

빟 D寃궗뿉 李몄뿬븯뒗 湲곌쓽 빟 24%뿉꽌 RhD 삁븸삎寃궗媛 쓬꽦씠怨 빟 D寃궗뿉꽌 뼇꽦씠뿀쓬뿉룄 遺덇뎄븯怨 RhD 뼇꽦쑝濡 蹂닿퀬븯뒗뜲, 씠뒗 삁븸썝뿉꽌 빟 D삎뿉 븯뿬 RhD 뼇꽦씠씪怨 媛꾩<븯뿬빞 븳떎뒗 궗떎怨 샎룞븯嫄곕굹[3] 샊 빟 D寃궗쓽 쓽誘몃 젣濡 뙆븙븯吏 紐삵븯湲 븣臾몄쑝濡 遺꾩꽍맂떎. 빟 D寃궗뿉 李몄뿬븳 遺遺꾩쓽 湲곌 쓽猷뚭린愿쑝濡 鍮꾨줉 씠 湲곌뱾쓽 긽떦닔媛 삁븸썝쓣 슫쁺븯怨좊뒗 엳쑝굹 遺遺 닔삁솚옄瑜 떎猷④퀬 엳뒗 湲곌씠떎. 씠윭븳 쓽猷뚭린愿뱾 닔삁솚옄뿉꽌 빟 D삎쓣 젙솗엳 뙋젙븯뿬 삤엳젮 RhD 쓬꽦뿉 以븯뿬빞 븯誘濡 씠뱾 湲곌뿉 븳 援먯쑁씠 븘슂븷 寃껋쑝濡 깮媛곷릺뿀떎.

2李 븣 諛쒖넚맂 옱議고빀 삁옣 寃泥대뒗 諛쒖넚맂 寃泥댁뿉 臾몄젣媛 엳뼱 鍮꾩삁湲고빆泥 꽑蹂 諛 룞젙쓽 뼇꽦 寃泥댁쓽 씪遺媛 룊媛릺吏 紐삵븯떎. 빆삁泥뿉 떊꽑룞寃고삁옣쓣 샎빀븳 1李⑥쓽 寃泥댁뒗 떖由 鍮꾩슜긽쓽 臾몄젣濡 2李 떆뒗 빆삁泥뿉 떇뿼닔瑜 泥④븯뿀떎. 듅엳 룞씪븳 떇뿼닔瑜 泥④븯쓬뿉룄 遺덇뎄븯怨 떎겢濡 빆泥댁씤 寃쎌슦뿉뒗 겙 쁺뼢씠 뾾뿀쑝굹 떒겢濡 빆泥댁씤 寃쎌슦뿉 솢꽦룄媛 湲됯꺽엳 븯릺뒗 쁽긽쓣 蹂댁떎. 씗꽍맂 빆泥대뱾(<1 mg/mL) 솢꽦룄媛 븯릺誘濡, 넂 냽룄濡 蹂닿븯嫄곕굹 샊 젙젣맂 냼삁泥씤 bovine serum albumin씠굹 젮씪떞怨 슫諛 샊 뿬怨 떒諛깆쭏쓣 理쒖쥌 냽룄媛 0.1%-0.5% 릺룄濡 泥④븷 븘슂媛 엳떎. 삉븳 떒諛깆쭏쓽 蹂꽦쓣 留됯린 쐞빐꽌뒗 떦瑜(sucrose, trehalose) 샊 뤃由ъ삱(polyol, 삁 glucerol, sorbitol) 벑쓽 븞젙젣 泥④媛 븘슂븯떎[4]. 1李 寃泥대뒗 슫諛 떒諛깆쭏씠굹 떦瑜섍 룷븿맂 삁옣쓣 샎빀븯뿬 빆삁泥 솢꽦룄뿉 臾몄젣媛 뾾뿀쑝굹 2李 寃泥대뒗 씠윭븳 臾쇱쭏 벑씠 뾾湲 븣臾몄뿉 빆泥 솢꽦룄媛 鍮⑤━ 냼떎릺뼱 李몄뿬湲곌쓽 寃궗 떦떆 痢≪젙릺吏 븡 湲곌뱾씠 留롮븯뜕 寃껋쑝濡 遺꾩꽍맂떎. 뵲씪꽌 뼢썑뿉뒗 듅엳 떒겢濡 빆삁泥쓣 궗슜븷 寃쎌슦뿉 씠쓽 씗꽍슜븸쑝濡 떊꽑룞寃고삁옣쓣 궗슜븯嫄곕굹 洹몃젃吏 紐삵븷 寃쎌슦뿉뒗 슫諛 떒諛깆쭏怨 떦瑜 벑쓽 泥④媛 븷 븘슂媛 엳寃좊떎. 씠 寃泥대 젣쇅븯怨좊뒗 鍮꾩삁湲고빆泥 꽑蹂꾧낵 룞젙寃궗뒗 슦닔븳 젙떟瑜좎쓣 蹂댁떎.

吏곸젒빆湲濡쒕텋由 寃泥댁쓽 닔媛 븳 쉶李⑤떦 湲곗〈쓽 2媛쒖뿉 鍮꾪븯뿬 2016뀈遺꽣 3媛쒕줈 利앷븯뒗뜲, 쓬꽦 寃泥댁쓽 寃쎌슦 IgG 떒듅씠꽦怨 C3d 떒듅씠꽦쓽 젙떟瑜좎씠 삁뀈뿉 鍮꾪븯뿬 利앷븳 寃쏀뼢쓣 蹂댁떎.

ABO 빆泥 뿭媛寃궗뿉 李몄뿬븯뒗 湲곌 닔媛 쟾뀈룄 34媛쒖뿉꽌 2016뀈룄뿉 42媛쒕줈 利앷븯쑝硫, 삁뀈怨 留덉갔媛吏濡 寃궗떎뱾 媛곴린 寃궗떎뿉 留욎텛뼱 뿬윭 媛吏 痢≪젙諛⑸쾿뱾쓣 궗슜븯怨 엳뿀떎. 1李⑥ 2李⑥쓽 뿀슜踰붿쐞 궡쓽 젙떟瑜좎씠 떎뼇븯湲곕뒗 븯굹, 젙떟瑜좎 쟾뀈룄 留덉갔媛吏濡 誘몄꽭썝二쇱쓳吏묐쾿 빆湲濡쒕텋由곕쾿씠 媛옣 넂븯떎. 誘몄꽭썝二쇱쓳吏묐쾿 빆湲濡쒕텋由곕쾿쓽 궗슜湲곌씠 떆뿕愿 빆湲濡쒕텋由곕쾿蹂대떎 留롮뜲, 쁽옱 援誘쇨굔媛뺤슂뼇湲됱뿬 湲곗쑝濡쒕뒗 誘몄꽭썝二쇱쓳吏묐쾿怨 떆뿕愿踰 벑쓽 寃궗踰 媛꾩뿉 李⑥씠媛 뾾떎뒗 臾몄젣젏씠 엳떎. 湲곌 媛꾩쓽 李⑥씠룄 쟻 誘몄꽭썝二쇱쓳吏묐쾿쓣 궗슜븯뒗 湲곌뱾씠 利앷븷 寃껋쑝濡 삁긽릺硫, 옱猷뚮퉬媛 떆뿕愿踰뺤뿉 鍮꾪븯뿬 鍮꾩떬 誘몄꽭썝二쇱쓳吏묐쾿쓣 씠슜븳 ABO 빆泥 뿭媛寃궗뿉 븳 쟻젅븳 닔媛泥닿퀎룄 븘슂븳 寃껋쑝濡 깮媛곷릺뿀떎.

李⑥꽭 떊鍮숇룄議곗궗궗뾽쓣 泥섏쓬쑝濡 떆뻾븳 2016뀈룄 4媛쒖쓽 닔삁쓽븰봽濡쒓렇옩쓽 10媛吏 醫낅ぉ쓣 떆뻾븯怨 씠뿉 븳 寃곌낵瑜 遺꾩꽍븯뿬 諛쒖넚븯湲곗뿉 李몄뿬湲곌뱾쓽 寃궗떎 뼢긽뿉 룄쓣 二쇱뿀쓣 寃껋쑝濡 룊媛븷 닔 엳뿀떎.

References
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