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Annual Report of the Korean Association of External Quality Assessment Service on Transfusion Medicine (2018)
J Lab Med Qual Assur 2019;41:65-74
Published online June 30, 2019
© 2019 Korean Association of External Quality Assessment Service.

Young Ae Lim1 and Hyun Soo Cho2

1Department of Laboratory Medicine, Ajou University School of Medicine; 2Department of Laboratory Medicine, Ajou University Hospital, Suwon, Korea
Correspondence to: Young Ae Lim, Department of Laboratory Medicine, 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
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

Herein, we report the results of the 2018 survey on the external quality assessment (EQA) scheme for the Transfusion Medicine Program (TMP) in Korea. The proficiency testing specimens were prepared at Ajou University Hospital and were sent to the participants biannually. The average accuracy rates for ten different test items on the regular survey were as follows: ABO typing, 99.5%–99.8% (N=841); RhD typing, 99.8%–100.0% (N=827); crossmatching, 89.4%–99.6% (N=708); ABO subtyping, 94.2% and 94.4% (N=53); Rh CcEe antigen testing, all 100.0% (N=51); weak D test, 80.9% (N=207) for the first trial and not graded for the second trial; antibody screening, 99.7%–100.0% (N=304); direct antiglobulin test (DAT) using a polyspecific reagent, 98.9%–100.0% (N=264); DAT using an immunoglobulin-G monospecific reagent, all 100.0% (N=66); DAT using a C3d monospecific reagent, 97.0%–100.0% (N=67); antibody identification, 98.4%–100.0% (N=127); and ABO antibody titration, 84.6%–100.0% (N=73). There were approximately 10.5% more participants in the 2018 EQA scheme than that in 2017. Excellent survey results were obtained in the 2018 EQA scheme compared with those in 2017, except for the weak D test. The 2018 EQA scheme for the TMP should be helpful for improving the quality of the participating laboratories.

Keywords : Transfusion medicine, Quality improvement, Laboratory proficiency testing
꽌濡

닔삁 쟾 寃궗쓽 젙솗꽦 솚옄쓽 깮紐낃낵룄 愿젴씠 엳쑝誘濡 젙솗꽦씠 蹂댁쬆릺뼱빞 븳떎. 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궗씠떎. 鍮꾨줉 씪遺 쓽猷뚭린愿뿉 硫댁뿭삁援ъ쓳吏묐쾿 寃궗뿉 븳 옄룞솕 옣鍮꾧 룄엯릺뿀湲곕뒗 븯굹 븘吏곷룄 닔湲곕쾿쑝濡 떆뻾븯怨 엳뒗 쓽猷뚭린愿씠굹 寃궗醫낅ぉ뱾씠 議댁옱븳떎. 씠윭븳 닔湲곕쾿 옄룞솕뿉 鍮꾪븯뿬 寃궗寃곌낵쓽 렪李④ 겢 닔 엳쑝硫 궗臾댁쟻씤 삤瑜 諛쒖깮媛뒫꽦룄 겕떎怨 蹂 닔 엳떎. 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ы삊쉶뿉꽌 2016뀈遺꽣 떆뻾븳 李⑥꽭 떊鍮숇룄議곗궗궗뾽쓽 닔삁쓽븰 愿젴 寃궗뱾 떎쓬怨 媛숈씠 4媛쒖쓽 봽濡쒓렇옩쑝濡 굹돇뼱 10媛吏쓽 빆紐⑹쑝濡 떆뻾븯怨 엳떎[1]. (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 antibody titration (ABO 빆泥 뿭媛寃궗). 씠 4媛쒖쓽 닔삁쓽븰봽濡쒓렇옩 2016뀈遺꽣 룞씪븳 닔삁쓽븰봽濡쒓렇 옩 愿由ъ옄뿉 쓽븯뿬 愿由щ릺怨 엳떎.

씠뿉 옄뱾 2018뀈뿉 4媛쒖쓽 닔삁쓽븰봽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 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 2016뀈룄遺꽣 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[2]. 寃泥 젣議곗뿉 궗슜맂 삁븸젣젣뱾 븳쟻떗옄궗 븳留덉쓬삁븸썝쑝濡쒕꽣 깮紐낆쑄由ъ떖쓽瑜 뱷븳 썑뿉 궗슜븯떎. 옄媛젣議곕맂 紐⑤뱺 寃泥대뒗 媛앷쟻 뙋룆쓣 쐞븯뿬 寃궗옄 2씤씠 媛곴컖 떆뿕愿踰뺢낵 寃붿뭅뱶踰뺤쑝濡(Bio-Rad Laboratories, DiaMed GmbH, Cressier, Switzerland) 寃궗븯뿬 寃곌낵 諛 삁援 쓳吏 젙룄瑜 솗씤븯떎. 븘二쇰븰援먮퀝썝뿉꽌 젣議곕릺怨 遺꾩< 썑 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 4썡 17씪, 2李⑤뒗 9썡 18씪뿉 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), 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 Alsever’s solution (Hemo Bioscience Inc., Morrisville, NC, USA)쓣 궗슜븯뿬 씗꽍븯떎. ABO 삁븸삎쓽 삁援ы삎 寃궗 RhD 삁븸삎 寃궗슜 삁援щ쑀븸 옄룞솕 옣鍮꾩뿉룄 궗슜씠 媛뒫븯룄濡 븯떎. 씠瑜 쐞븯뿬 20% 쓽 옱議고빀 쟾삁씠 릺룄濡 룞삎쓽 떊꽑룞寃고삁옣怨 Alsever’s solution (Hemo Bioscience Inc.)쑝濡 씗꽍븯怨, ABO 븘 삎 삁븸삎, Rh CcEe 빆썝寃궗 洹몃━怨 빟 D寃궗슜 쟻삁援 遺쑀븸 Alsever’s solution (Hemo Bioscience Inc.)쑝濡 5%媛 릺룄濡 븯떎. 援먯감떆뿕슜 쟻삁援 遺쑀븸 3媛쒖쓽 ABO 삁븸삎쓽 삁援ы삎 寃궗슜 寃泥 以 븯굹瑜 궗슜븯룄濡 븯떎. ABO 븘삎 삁븸삎怨 빟 D寃궗 寃泥대뒗 CPDA (citrate phosphate dextrose adenine)-1 삁븸 諛깆뿉꽌 遺꾨━맂 냽異뺤쟻삁援щ 궗슜 븯떎[1,2]. 룞씪븳 ABO 삁븸삎쓽 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 꽦遺꾩콈삁삁옣쓣 궗슜븯떎. 삁븸 諛깆쓽 샎二 떆뒗 臾닿퇏遊됲빀湲곕줈 뿰寃고븯뿬 샎빀븳 떎쓬 遺꾩<븯떎. ABO 삁븸삎쓽 삁泥슜 寃泥닿 삁援ы삎뿉 鍮꾪븯뿬 삁援ъ쓳吏묒씠 빟븯뿬 遺덉씪移섎 蹂댁씪 寃쎌슦 떒겢濡 빆泥 immunoglobulin M 떆빟씤 빆-A 빆-B瑜 二쇱궗湲곗뿉 떞븘 肄뷀뵆윭瑜 냼룆븳 썑 二쇱궗湲곕 苑귥븘 빆삁泥쓣 二쇱엯븯뿬 媛뺣룄瑜 넂떎.

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)뒗 鍮꾩삁湲고빆泥 룞젙寃궗(2媛)뒗 빆 삁泥뿉 꽦遺꾩콈삁삁옣쑝濡 씗꽍븯뿬 옱議고빀븯떎. 援먯감떆뿕 뼇꽦 寃泥대뒗 빆湲濡쒕텋由 떒怨꾩뿉꽌留 寃異쒕릺怨 洹 쇅쓽 떒怨꾩뿉 꽌뒗 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 anti-D (DiaMed GmbH)瑜 AB삎 꽦遺꾩콈삁삁옣뿉 씗꽍븯뿬 궗슜븯떎[1,2].

鍮꾩삁湲고빆泥 꽑蹂꾧궗슜 뼇꽦 寃泥대줈뒗 1쉶李, 2쉶李 빆-D 빆泥대 諛쒖넚븯怨, 룞젙슜 뼇꽦 寃泥대줈뒗 1쉶李 빆-E 빆泥, 빆-Fyb 빆泥대, 2쉶李 빆-C 빆-D 빆泥, 빆-K 빆泥대 諛쒖넚븯 떎. 寃泥대뒗 긽뭹솕맂 빆삁泥 떆빟쓣 媛곴컖 씗꽍븯뿬 궗슜븯뒗뜲, 궗슜맂 빆삁泥 떆빟쓽 醫낅쪟뒗 媛곴컖 떎겢濡좎꽦 빆-D 빆泥 (DiaMed GmbH), 떒겢濡좎꽦 빆-E, 빆-C, 빆-K 빆泥(Diagast, Parc Eurasanté, France), 떎겢濡좎꽦 빆-Fyb 빆泥(Diagast)떎. 씗꽍 떆뒗 AB 삁븸삎쓽 꽦遺꾩콈삁삁옣뿉 씗꽍븯떎[1,2].

4) 吏곸젒빆湲濡쒕텋由곌궗슜 삁援 젣議

뼇꽦 吏곸젒빆湲濡쒕텋由곌궗슜 寃泥대뒗 씤媛꾩쑀옒 떎겢濡좎꽦 빆-D 빆泥(DiaMed GmbH)瑜 궗슜븯뿬 씤쐞쟻쑝濡 媛먯옉떆궓 삁援щ 궗슜븯떎. 쓬꽦 吏곸젒빆湲濡쒕텋由곌궗슜 삁援щ뒗 吏곸젒빆湲濡쒕텋由곌궗 寃곌낵 쓬꽦씤 쟻삁援щ 궗슜븯떎. 뼇꽦 諛 쓬꽦 삁援щ뱾 삁援щ낫議댁븸씤 Alsever’s solution (Hemo Bioscience Inc.)뿉 10%濡 씗꽍븯뿬 씠슜븯떎.

3. 寃곌낵 뙋젙 諛 遺꾩꽍 寃泥

빐떦 寃궗瑜 떆뻾븯湲곗뿉 쟻젅븯吏 븡 slide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 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. 李몄뿬湲곌씠 10湲곌 誘몃쭔씤 寃쎌슦뿉뒗 code 501쓣 궗슜븯뿬 룊媛븯吏 븡븯떎. 援먯감떆뿕쓽 諛⑸쾿蹂 삁援ъ쓳吏 젙룄 吏곸젒빆湲 濡쒕텋由곌궗쓽 삁援ъ쓳吏 젙룄뒗 븞궡臾몄뿉 怨듭븳 濡 빐떦 寃泥댁뿉 빐 빀쓽맂 寃곕줎쓣 룄異쒗븯怨 룊媛븯쑝굹, 寃궗빆紐⑹씠 援먯쑁紐⑹쟻씠씪 씤利앺룊媛뿉뒗 遺덊룷븿븯뒗 code 520쓣 궗슜븯떎. 삉븳 빐떦 寃泥댁뿉 빐 빀쓽맂 寃곕줎쓣 룄異쒗븷 닔 뾾쓣 寃쎌슦뿉뒗 code 505瑜 궗슜븯怨, 빐떦 湲곌씠 궗슜븯뒗 湲곌린 諛 떆빟뿉꽌뒗 빀쓽맂 寃곕줎씠 룄異쒕릺뿀쑝굹 쓽룄맂 寃곌낵 삉뒗 뿰愿맂 寃궗醫낅ぉ쓽 寃곌낵 긽씠븯뿬 룊媛瑜 븷 닔 뾾뒗 寃쎌슦뿉뒗 code 506쓣 궗슜븯뿬 紐⑤몢 룊媛뿉꽌 젣쇅븯떎.

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 룊洹 李몄뿬湲곌 닔뒗 841媛 湲곌쑝濡 쟾뀈룄 鍮 17.7%媛 利앷븯怨, 젙떟瑜좎 99.5%-99.8%瑜 굹깉떎(Table 1). 1 李(2李)쓽 삁援ы삎 寃궗踰뺤 뒳씪씠뱶踰 54.2% (54.3%), 떆뿕 愿踰 37.3% (36.7%) 닚씠뿀쑝硫, 1李(2李)쓽 삁泥삎 寃궗踰 떆뿕愿踰뺤씠 81.3% (81.7%), 뒳씪씠뱶踰 11.1% (10.1%) 닚쑝濡 굹궗떎.

Table 1 . Number (%) of participants in the proficiency testing for ABO blood grouping in 2018.

TrialSpecimenTotalABOABDisIntended response
1BB-18-01839 (100.0)2 (0.2)836 (99.7)--1 (0.1)B
BB-18-02839 (100.0)--836 (99.6)-3 (0.4)O
BB-18-03839 (100.0)837 (99.8)-1 (0.1)-1 (0.1)A
2BB-18-07842 (100.0)1(0.1)838 (99.5)-3 (0.4)B
BB-18-08842 (100.0)--840 (99.8)-2 (0.2)O
BB-18-09842 (100.0)---840 (99.8)2 (0.2)AB

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

Abbreviation: Dis, discrepancy between cell typing and serum typing..


RhD 삁븸삎寃궗룄 2李⑥뿉 嫄몄퀜 珥 6媛쒖쓽 寃泥대줈 떎떆븯怨, 룊洹 李몄뿬湲곌 닔뒗 827媛 湲곌쑝濡 쟾뀈룄 鍮 19.0% 媛 利앷븯怨, 젙떟瑜좎 99.5%-100.0%瑜 굹궡뼱 옉뀈룄뿉 鍮꾪븯뿬 젙떟瑜좎씠 냼룺 利앷븯떎(Table 2). 1李(2李)쓽 寃궗踰뺤 1李⑥뿉꽌뒗 떆뿕愿踰뺤씠 44.2% (42.8%), 뒳씪씠뱶踰 47.3% (48.1%) 닚씠뿀떎.

Table 2 . Number (%) of participants in the proficiency testing for RhD typing in 2018.

TrialSpecimenTotalPositiveVariantNegativeNAIntended response
1stBB-18-01823 (100.0)823 (100.0)---Positive
BB-18-02823 (100.0)823 (100.0)---Positive
BB-18-03823 (100.0)3 (0.4)1 (0.1)819 (99.5)-Negative
2ndBB-18-07831 (100.0)1 (0.1)1 (0.1)829 (99.8)-Negative
BB-18-08831 (100.0)831 (100.0)---Positive
BB-18-09831 (100.0)831 (100.0)---Positive

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, 룊洹 李몄뿬湲곌 닔뒗 708媛 湲곌쑝濡 쟾뀈룄 鍮 14.6%媛 利앷븯떎. 쟻빀 寃泥대뒗 99.2%-99.6%, 遺쟻빀 寃泥대뒗 89.4% 92.1%쓽 援먯감떆뿕 뙋젙 젙떟瑜좎쓣 蹂댁뿬 96.5%쓽 룊洹 젙떟瑜좎쓣 蹂댁떎(Table 3). 遺쟻빀 寃泥댁쓽 寃쎌슦 媛 諛⑸쾿蹂꾨줈 遺꾩꽍븳 寃곌낵, 떆뿕愿踰뺤쓽 떇뿼닔떒怨꾩 37°C 븣遺誘쇰떒怨꾩뿉꽌뒗 遺遺꾩쓽 湲곌뿉꽌 쓬꽦쑝濡 蹂닿퀬븳 諛섎㈃, 遺遺꾩쓽 떆뿕愿踰 빆湲濡쒕텋由곕떒怨꾩 썝二쇱쓳吏묐쾿 1+ 씠긽쓽 쓳吏묒쓣 굹궡뿀떎 (Fig. 1).

Table 3 . Number and percentage of participants in the proficiency testing for blood crossmatching in 2018.

Trial (RBC)SpecimenIntended responseResultsNumber (%)
1st (BB-18-02)BB-18-04CompatibleAcceptable706 (99.6)
Unacceptable3 (0.4)
BB-18-05IncompatibleAcceptable634 (89.4)
Unacceptable75 (10.6)
BB-18-06CompatibleAcceptable703 (99.2)
Unacceptable6 (0.8)
2nd (BB-18-08)BB-18-10CompatibleAcceptable703 (99.4)
Unacceptable4 (0.6)
BB-18-11IncompatibleAcceptable651 (92.1)
Unacceptable56 (7.9)
BB-18-12CompatibleAcceptable703 (99.4)
Unacceptable4 (0.6)

Abbreviation: RBC, red blood cell..


Figure 1.

(A, B) Number of participants (Y axis) according to the grade of hemagglutination strength (X axis) of incompatible samples for blood crossmatching in 2018. *The number of participants using tube-saline.


2. 듅닔 닔삁빆썝寃궗

1) ABO 븘삎 삁븸삎

룊洹 李몄뿬湲곌 닔뒗 53媛 湲곌쑝濡 쟾뀈룄 鍮 3.9%媛 利앷븯떎. 1李 寃泥대뒗 A2Bw삎쑝濡 94.2% (49/51)쓽 젙떟瑜좎쓣 蹂댁뒗뜲 빆-B 떆빟怨쇱쓽 諛섏쓳뿉꽌 100.0% 湲곌뿉꽌 샎빀 떆빞瑜 룷븿븯뿬 trace遺꽣 3+源뚯쓽 쓳吏묒쓣 蹂닿퀬븯쑝硫, 2媛 湲곌쓣 젣쇅븳 96.2%뿉꽌 B 븘삎쓣 寃異쒗븯떎. 빆-H 떆빟怨쇱쓽 諛섏쓳뿉꽌 1+ 씠긽쓣 蹂닿퀬븳 湲곌 98.0%떎. 2李 寃泥대뒗 A1Bw삎쑝濡 94.4% (51/54)쓽 젙떟瑜좎쓣 蹂댁떎. 빆-B 떆빟怨쇱쓽 諛섏쓳뿉꽌 샎빀떆빞瑜 룷븿븯뿬 trace遺꽣 3+源뚯쓽 쓳吏묒쓣 蹂닿퀬븳 湲곌 96.3%쑝硫 2湲곌쓣 젣쇅븳 96.3%뿉꽌 B 븘삎쓣 寃異쒗븯떎. 빆-H 떆빟怨쇱쓽 諛섏쓳뿉꽌 2媛 湲곌쓣 젣쇅븯怨좊뒗 紐⑤뱺 湲곌뿉꽌 1+ 씠긽쓣 蹂닿퀬븯뿬 96.2%떎 (Table 4).

Table 4 . Number (%) of participants in the proficiency testing for ABO subtyping in 2018.

Trial (specimen)CategoryAnti-seraABO subgroup

Anti-AAnti-BAnti-A1Anti-H
1st (BGS-18-01)Number52525249A2B2 (3.8)*
Negative--52 (100.0)1 (2.0)A2Bw49 (94.2)
±-1 (1.9)*--AwBw1 (1.9)*
1+-5 (9.6)-2 (4.1)--
2+-22 (42.3)-4 (8.1)--
3+3 (5.8)10 (19.2)-21 (42.9)--
4+49 (94.2)--21 (42.9)--
MF-14 (26.9)----
2nd (BGS-18-04)Number54545452A12 (3.7)*
Negative-2 (3.7)1 (1.9)2 (3.8)A1Bw51 (94.4)
±-4 (7.4)-2 (3.8)A2Bw1 (1.9)*
1+-25 (46.3)1 (1.9)22 (42.3)--
2+-5 (9.3)2 (3.7)24 (46.2)--
3+--3 (5.7)2 (3.8)--
4+54 (100.0)-47 (88.7)---
MF-18 (33.3)----

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

Abbreviation: MF, mixed field agglutination..

*Unacceptable responses for ABO subgrouping.


2) Rh CcEe 빆썝寃궗

Rh CcEe 빆썝寃궗뒗 1李⑥ 2李 紐⑤몢 51媛 湲곌뿉꽌 李몄뿬븯쑝硫, 1李⑥ 2李 寃泥 紐⑤몢 CcEe 寃泥대 諛쒖넚븯뒗뜲, 삁븸삎 뙋젙쓣 떎떆븳 湲곌 1李 47媛 湲곌 洹몃━怨 2李 46媛 湲곌쓽 寃泥댁뿉꽌留 蹂닿퀬븯쑝硫, 2+瑜 蹂닿퀬븳 씪遺 湲곌쓣 젣쇅븯怨좊뒗 紐⑤몢 3+ 씠긽쓽 삁援ъ쓳吏묒쓣 蹂닿퀬븯뿬 2李 寃泥댁쓽 C 빆썝쓣 젣쇅븳 굹癒몄 빆썝 3+ 씠긽쓣 젙떟쑝濡 媛꾩<븯떎(Table 5).

Table 5 . Number (%) of participants in the proficiency testing for Rh CcEe antigen typing in 2018.

Trial (specimen)CategoryAnti-seraPhenotype

CEce
1st (BGS-18-02)Number51515151CcEe 47 (100.0)
1+----
2+1 (2.0)1 (2.0)2 (3.9)-
3+17 (33.3)15 (29.4)13 (25.5)13 (25.5)
4+33 (64.7)35 (68.6)36 (70.6)38 (74.5)
2nd (BGS-18-05)Number51515151CcEe 46 (100.0)
Negative----
1+----
2+1 (2.0)2 (3.9)5 (9.8)4 (7.8)
3+24 (47.1)14 (27.5)15 (29.4)19 (37.3)
4+26 (50.9)35 (68.6)31 (60.8)28 (54.9)

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


3) 빟 D寃궗

룊洹 李몄뿬湲곌 닔뒗 207媛 湲곌쑝濡 쟾뀈룄 鍮 37.5%媛 利앷븯뿬 닔삁쓽븰봽濡쒓렇옩 醫낅ぉ 以 媛옣 留롮씠 利앷븯떎. 1李⑥뿉 諛쒖넚맂 寃泥대뒗 72.5% 湲곌뿉꽌 RhD 삁븸삎寃궗뿉꽌뒗 쓬꽦쓣 蹂댁쑝굹 80.9%뿉꽌 D 蹂씠삎쑝濡 蹂닿퀬븯떎. 諛섎㈃ 2李⑥뿉 諛쒖넚맂 寃泥대뒗 99.0% 湲곌뿉꽌 RhD 삁븸삎寃궗뿉꽌 쓬꽦쓣 蹂댁쑝硫 34.8%留뚯씠 쓽룄븯뜕 D 蹂씠삎쑝濡 蹂닿퀬븯怨, D 쓬꽦쑝濡 蹂닿퀬븳 湲곌룄 63.8%굹 릺뼱 쓽룄븳 떟蹂怨 긽떦닔쓽 湲곌뱾씠 蹂닿퀬븳 떟蹂뱾 媛꾩쓽 긽씠븳 李⑥씠瑜 蹂댁뿬 code 506쑝濡 泥섎━븯怨 룊媛뿉꽌 젣쇅븯떎(Table 6).

Table 6 . Number (%) of participants in the proficiency testing for weak D test in 2018.

Trial (specimen)1 (BGS-18-03)2 (BGS-18-06)


RhDWeak DRhDWeak D
Number207208205206
Negative150 (72.5)*3 (1.4)203 (99.0)*131 (63.6)
±32 (15.5)*-1 (0.5)*23 (11.2)
1+18 (8.7)*19 (9.1)-39 (18.9)
2+7 (3.4)*54 (26.0)1 (0.5)*11 (5.3)
3+-76 (63.5)-2 (1.0)
4+-52 (25.0)--
Not done-4 (1.9)--
D positive2 (1.0)3 (1.4)*
D variant169 (80.9)72 (34.8)*
D negative38 (18.2)132 (63.8)*

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

*Not graded due to lack of participants’ consensus or participants’ consensus different from the intention.

Unacceptable responses for weak D testing.


3. 씪諛 닔삁빆泥닿궗

1) 鍮꾩삁湲고빆泥 꽑蹂꾧궗

룊洹 李몄뿬湲곌 닔뒗 304湲곌쑝濡 쟾뀈룄 鍮 4.3%媛 利앷븯怨, 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쒖넚븯떎. 1李 寃泥대뒗 993%-100.0%, 洹몃━怨 2李 寃泥댁뿉꽌뒗 99.7%-100.0%쓽 젙떟瑜좎쓣 蹂댁떎(Table 7). 1李(2李) 寃궗踰뺤쓽 鍮꾩쑉 썝二쇱쓳吏묐쾿 94.4% (94.0%), 떆뿕愿踰 3.6% (2.0%), 洹몃━怨 굹癒몄 寃궗踰뺤씠 3.6% (4%)瑜 李⑥븯떎.

Table 7 . Number (%) of participants in the proficiency testing for antibody screening in 2018.

TrialSpecimenNumberResultIntended

PositiveNegative
1stBBG-18-01305305 (100.0)-Positive
BBG-18-023051 (0.3)*304 (99.7)Negative
BBG-18-03305303 (99.3)2 (0.7)*Positive
2ndBBG-18-07300-300 (100.0)Negative
BBG-18-08300299 (99.7)1 (0.3)*Positive
BBG-18-09300300 (100.0)-Positive

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

*Unacceptable responses for antibody screening.


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 궗슜릺뿀떎. 떎듅씠꽦 빆湲濡쒕텋由곌궗뒗 4媛쒖쓽 쓬꽦 寃泥댁뿉 븯뿬 99.2%-100.0% 2媛쒖쓽 뼇꽦 寃泥댁뿉 븯뿬 98.9%-100.0% 쓽 젙떟瑜좎쓣 蹂댁쑝硫, 룊洹 李몄뿬湲곌 닔뒗 264媛 湲곌쑝濡 쟾뀈룄 鍮 3.3%媛 利앷븯떎. Immunoglobulin G 떒듅씠꽦 빆湲濡쒕텋由곌궗뒗 6媛쒖쓽 紐⑤뱺 寃泥댁뿉꽌뒗 삁뀈泥섎읆 100.0% 쓽 젙떟瑜좎쓣 蹂댁떎. 洹몃윭굹 C3d 떒듅씠꽦 빆湲濡쒕텋由곌궗쓽 寃쎌슦, 6媛쒖쓽 쓬꽦 寃泥댁뿉꽌 97.0%-100.0%쓽 젙떟瑜좎쓣 蹂댁떎(Table 8). 李멸湲곌뱾 썝二쇱쓳吏묐쾿怨 떆뿕愿踰뺤쓣 궗슜븯怨 엳뒗뜲, 떎듅씠꽦 빆湲濡쒕텋由곌궗쓽 썝二쇱쓳吏묐쾿怨 떆뿕愿踰뺤쓽 궗슜鍮꾩쑉 寃쎌슦 1李 68.9% 31.1%, 2李⑥쓽 寃쎌슦

Table 8 . Number (%) of participants in the proficiency testing for direct antiglobulin test in 2018.

TrialAntiglobulinSpecimenNumberResultIntended response

PositiveNegative
1stPolyspecificBBG-18-04264261 (98.9)3 (1.1)Positive
BBG-18-051 (0.4)*263 (99.6)Negative
BBG-18-061 (0.4)*263 (99.6)Negative
Anti-IgGBBG-18-046666 (100.0)-Positive
BBG-18-05-66 (100.0)Negative
BBG-18-06-66 (100.0)Negative
Anti-C3dBBG-18-04672 (3.0)*65 (97.0)Negative
BBG-18-05-67 (100.0)Negative
BBG-18-061 (1.5)*66 (98.5)Negative
2ndPolyspecificBBG-18-10264-264 (100.0)Negative
BBG-18-112 (0.8)*262 (99.2)Negative
BBG-18-12263 (99.6)1 (0.4)*Positive
Anti-IgGBBG-18-1065-65 (100.0)Negative
BBG-18-11-65 (100.0)Negative
BBG-18-1265 (100.0)-Positive
Anti-C3dBBG-18-1066-66 (100.0)Negative
BBG-18-11-66 (100.0)Negative
BBG-18-122(3.0)*64 (97.0)Negative

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

Abbreviation: IgG, immunoglobulin G..

*Unacceptable responses for direct antiglobulin test.


4. 듅닔 닔삁빆泥닿궗

1) 鍮꾩삁湲고빆泥 룞젙寃궗

룊洹 李몄뿬湲곌 닔뒗 127湲곌쑝濡 쟾뀈룄 鍮 3.4%媛 利앷븯怨, 媛 빆泥대퀎 룞젙寃궗쓽 젙떟瑜좎 빆-E 빆泥댁 빆-K 빆泥대뒗 紐⑤몢 100.0%, 빆-Fyb 빆泥대뒗 98.4%쓽 슦닔븳 젙떟瑜좎쓣 굹궡뿀떎. 빆-C 빆-D 빆泥 議고빀씤 寃쎌슦 97.6%쓽 젙떟瑜 쓣 굹궡뿀쑝굹 빆-D 빆泥대쭔 寃異쒗븳 湲곌씠 2媛 湲곌 洹몃━怨 빆泥대 寃異쒗븯吏 紐삵븳 湲곌 1媛 湲곌쑝濡 씠뱾 3媛 湲곌쓽 寃곌낵뒗 삤떟쑝濡 泥섎━븯떎(Table 9).

Table 9 . Number (%) of participants in the proficiency testing for antibody identification in 2018.

TrialSpecimenNumberIntended responseOther responses (no. of participants)

 AntibodyNumber (%)
1BBS-18-01128Anti-E128 (100.0)
BBS-18-02128Anti-Fyb126 (98.4)Anti-Fya (1), anti-K (1)
2BBS-18-04126Anti-C+anti-D123 (97.6)Anti-D (2), not detected (1)
BBS-18-05126Anti-K126 (100.0)

2) ABO 빆泥 뿭媛寃궗

룊洹 李몄뿬湲곌 닔뒗 73湲곌쑝濡 쟾뀈룄 룞씪븯怨, 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. 빆-A 빆泥댁쓽 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 97.6%, 떆뿕愿 떎삩諛곗뼇踰뺢낵 떆뿕愿 빆湲濡쒕텋由곕쾿 紐⑤몢 100.0.0%, 썝二쇱쓳吏 떎삩踰 紐⑤몢 91.7%, 썝二쇱쓳吏 빆湲濡쒕텋由곕쾿 紐⑤몢 92.6% 81.5%떎. 빆-B 빆泥댁쓽 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 94.6% 97.3%, 떆뿕愿 떎삩諛곗뼇踰뺤100.0% 95%, 떆뿕愿 빆湲濡쒕텋由곕쾿 88.2% 100.0%, 썝二쇱쓳吏 떎삩踰 紐⑤몢 91.7%, 썝二쇱쓳吏 빆湲濡쒕텋由곕쾿 96.4% 100.0%떎(Table 10). 寃궗踰뺤 떆뿕愿 利됱떆썝移⑤쾿쓣 궗슜븯뒗 湲곌씠 룊洹 39媛 湲곌쑝濡 媛옣 留롮븯쑝硫, 썝二쇱쓳吏 빆湲濡쒕텋由곕쾿 28媛 湲곌, 떆뿕愿 떎삩諛곗뼇踰뺢낵 떆뿕愿 빆湲濡 遺덈┛踰뺤씠 媛곴컖 17媛 湲곌, 썝二쇱쓳吏 떎삩踰 12媛 湲곌 닚쑝濡 굹궗떎.

Table 10 . Number of participants according to the techniques for ABO antibody titration in 2018.

TechniqueTrialNumberAcceptable range (%)Titer

481632641282565121,024
Anti-A
 CAT-AHG1st2792.61213101
 CAT-AHG, DTT5122
 CAT-RT1291.75421
 Others11
 Tube-AHG17100.089
 Tube-AHG, DTT532
 Tube-RT19100.0892
 Tube-IS4197.611822
 Total127113257252
 CAT-AHG2nd2896.416129
 CAT-AHG, DTT422
 CAT-RT1291.7174
 Others11
 Tube-AHG1788.23752
 Tube-AHG, DTT41111
 Tube-RT20100.01154
 Tube-IS3794.61151911
 Total1232164314142014
Anti-B
 CAT-AHG1st2781.5148113
 CAT-AHG, DTT5122
 CAT-RT1291.72721
 Others11
 Tube-AHG17100.0485
 Tube-AHG, DTT5212
 Tube-RT19100.06121
 Tube-IS4197.6115196
 Total12753449309
 CAT-AHG2nd28100.08146
 CAT-AHG, DTT413
 CAT-RT1291.71182
 Others11
 Tube-AHG17100.0935
 Tube-AHG, DTT4112
 Tube-RT2095.031331
 Tube-IS3797.318226
 Total12321245302311

Bold type signifies acceptable range..

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


怨좎같

寃궗뿉 李몄뿬븳 湲곌 닔뒗 2017뀈룄뿉 鍮꾪븯뿬 2018뀈룄뿉룊洹 10.5% 利앷븯뒗뜲, 쟾뀈룄뿉 鍮꾪븯뿬 媛옣 留롮씠 利앷븳 寃궗醫낅ぉ 빟 D寃궗濡 37.5%媛 利앷븯떎. 씠 쇅뿉룄 ABO 삁븸삎寃궗 17.7%, RhD 삁븸삎寃궗 19%, 洹몃━怨 援먯감 떆뿕쓽 寃쎌슦 14.6%濡 씪諛섏닔삁寃궗쓽 李몄뿬湲곌 닔媛 쟾뀈룄뿉 鍮꾪븯뿬 留롮씠 利앷븯떎. 씠뒗 쟾뀈룄 遺꾩꽍怨 留덉갔媛吏濡 2017뀈 7썡遺꽣 嫄닿컯蹂댄뿕 벑뿉 ‘寃泥닿궗 吏덇궛’젣룄媛 떊꽕맖뿉 뵲瑜 쁺뼢쑝濡 뿬寃⑥쭊떎[2].

2017뀈遺꽣뒗 떎젣 寃궗떎 솚寃쎌쓣 諛섏쁺븯湲 쐞븯뿬 젙룄愿由ъ슜 寃泥대 20%쓽 옱議고빀 쟾삁씠 릺룄濡 냽異뺤쟻삁援ъ 꽭룷 蹂댁〈븸쑝濡 씗꽍븯뿬 젣議고븯떎. 쟾삁 20%뒗 15%濡 븣젮吏 샇二쇱쓽 젙룄愿由ы봽濡쒓렇옩씤 Royal College of Pathologists of Australasia쓽 寃泥대낫떎 쟻삁援 냽룄媛 넂븘 떎젣 솚옄 寃泥댁 뜑 쑀궗븯寃 젣議고븯怨좎옄 븯떎. 洹몃윭굹 씪遺 옄룞솕 옣鍮 뿉꽌뒗 뿬쟾엳 꽭룷蹂댁〈븸 븣臾몄뿉 삁泥삎 寃궗媛 遺덇뒫븳 寃쎌슦룄 엳뼱 씠뱾 湲곌뿉 븳빐꽌뒗 룞삎쓽 떊꽑룞寃고삁옣怨 빆삁泥쓣 泥④븯뿬 쑀궗븳 ABO 빆泥 뿭媛瑜 媛吏룄濡 젣議고븯떎. 뵲씪꽌 李몄뿬湲곌쓽 옄룞솕 옣鍮꾩쓽 醫낅쪟뿉 뵲씪 紐⑺몴 寃곌낵 媛믪 씪젙븯릺 쇅遺떊鍮숇룄 寃泥 議곗꽦 떖由 留뚮뱾뼱빞 맆 븘슂룄 엳寃좊떎.

2017뀈룄뿉뒗 씪諛섏닔삁寃궗쓽 삁援ъ쓳吏 媛뺣룄瑜 紐⑤몢 떆踰 빆紐⑹쑝濡 媛꾩<븯뿬 룊媛뿉꽌 젣쇅븯쑝굹, 2018뀈 룊媛뿉꽌뒗 삁援ъ쓳吏 媛뺣룄瑜 삁븸삎 寃곌낵엯젰봽濡쒓렇옩쓽 엯젰 븘닔궗 빆쑝濡 蹂寃쏀븯怨 씠瑜 븞궡臾몄뿉 怨듭븯떎. 利 삁븸삎寃 궗떆뒗 쓳吏 젙룄瑜 꽑깮븯뿬 엯젰븳 썑 뙋젙뿉 理쒖쥌 삁븸삎쓣 엯젰븯룄濡 븯怨, ABO 삁븸삎寃궗 떆 삁援ы삎留 떎떆븯쓣 寃쎌슦 삁泥삎 寃궗쓽 A cell怨 B cell쓽 2媛 빆紐⑹쓣 遺쟻빀쑝濡 泥섎━븳떎怨 怨듭븯떎. 씠윭븳 쁺뼢 뜒遺꾩쑝濡 2018뀈뿉뒗 李몄뿬湲곌 紐⑤몢媛 삁븸삎寃궗뿉꽌 삁援 쓳吏 젙룄瑜 엯젰븯怨 ABO 삁븸삎寃궗쓽 寃쎌슦 삁援ы삎怨 삁泥삎쓣 븿猿 떆뻾븯뒗 꽦怨쇰 媛졇삤寃 릺뿀떎. 2017뀈룄 1李⑥ 2李⑥쓽 寃쎌슦 삁泥삎 寃궗瑜 떎떆븯吏 븡 湲곌쓽 鍮꾩쑉씠 4.7% 5.5%瑜 李⑥븯떎뒗 궗떎쓣 怨좊젮븷 븣 留ㅼ슦 怨좊Т쟻씤 쁽긽씠씪怨 븷 닔 엳떎[2]. 뵲씪꽌 寃곌낵엯젰봽濡쒓렇옩쓽 蹂寃쎄낵 袁몄븳 븞궡臾몄쓽 怨듭뒗 李몄뿬湲곌쓽 援먯쑁슚怨쇱뿉룄 留ㅼ슦 슚쑉쟻엫쓣 븣 닔 엳뿀 떎. 洹몃윭굹 삁븸삎寃궗뿉 李몄뿬븯뒗 珥 湲곌 닔뒗 利앷븳 떊 쟾뀈룄뿉 鍮꾪븯뿬 뒳씪씠뱶踰뺤쓣 떆뻾븯뒗 湲곌 利앷븯怨, 沅뚯옣릺뒗 떆뿕愿踰뺤 媛먯냼븯떎.

遺쟻빀 援먯감떆뿕 寃泥댁쓽 젙떟瑜좎 쟾뀈룄뿉 鍮꾪븯뿬 긽듅븯 쑝굹, 쟾뀈룄 留덉갔媛吏濡 떆뿕愿 떇뿼닔踰뺤뿉꽌 뼇꽦쓣 蹂닿퀬븯嫄곕굹 떆뿕愿 빆湲濡쒕텋由 떒怨꾩뿉꽌 쓬꽦쓣 蹂댁씠뒗 湲곌뱾씠 뿬쟾엳 議댁옱븯뿬 씠뱾 湲곌뿉 븳 삱諛붾Ⅸ 援먯감떆뿕 寃궗踰 援먯쑁씠 븘슂븳 寃껋쑝濡 뿬寃⑥죱떎.

ABO 븘삎 寃궗쓽 젙떟瑜좎 쟾뀈룄 96.0% 80.7%뿉 鍮꾪븯뿬 긽듅븳 94.2% 94.4%瑜 蹂댁뿬 뼢긽맂 寃곌낵瑜 蹂댁뿬二쇱뿀뒗뜲, 씠뒗 B 븘삎뿉 븳 빆-B 떆빟쓽 삁泥삎 寃궗뿉꽌 3+ 씠긽쓽 쓳吏묒쓣 蹂댁씠뒗 湲곌씠 1李⑥뿉뒗 19.2%, 2李⑥뿉뒗 0媛 湲곌쑝濡 留ㅼ슦 媛먯냼븯湲 븣臾몄쑝濡 遺꾩꽍릺뿀떎. 洹몃윭굹 2李 寃泥 뿉꽌 B빆썝쓣 寃異쒗븯吏 紐삵븳 湲곌룄 2湲곌씠굹 릺뿀湲곗뿉 쟾뀈룄뿉 鍮꾪븯뿬 遺遺꾩쓽 李몄뿬湲곌뱾씠 B 븘삎쓣 뙋젙븯뒗 뒫젰씠 뼢긽릺뿀吏留 2李 寃泥닿 떎瑜 떆湲곗쓽 寃泥댁뿉 鍮꾪븯뿬 B빆썝씠 뜑 빟븯湲 븣臾몄뿉 젙긽 B삎쑝濡 뙋젙븯뒗 寃쎌슦룄 媛먯냼븯 湲 븣臾몄씤 寃껋쑝濡 깮媛곷릺뿀떎. 빟븯寃 몴쁽릺뒗 ABO 븘삎뱾 옒紐 寃궗 떆 O삎쑝濡 뙋젙맆 닔 엳떎[3,4]. 씠瑜 寃異쒗븯吏 紐삵븯뿬 젙솗븯寃 삁븸삎쓣 뙋젙븯吏 紐삵븷 寃쎌슦 닔삁옄뒗 룞씪븳 삁븸삎쓽 삁븸쓣 닔삁諛쏅뒗뜲 듅蹂꾪븳 臾몄젣媛 뾾쓣 닔 엳쑝굹, 뿄삁옄뒗 솚옄뿉寃 빆泥대 쑀諛쒗븯嫄곕굹 슜삁닔삁 씠긽諛섏쓳쓣 珥덈옒븷 媛뒫꽦씠 엳떎. 뵲씪꽌 삁븸썝씠굹 삁븸썝쓣 슫쁺븯뒗 쓽猷뚭린愿뿉꽌쓽 뿄삁옄쓽 삁븸삎寃궗뒗 留ㅼ슦 以묒슂븯硫, 삁븸썝쓣 슫쁺븯吏 븡뒗 쓽猷뚭린愿룄 솚옄뿉寃 젙솗븳 삁븸삎쓣 젙蹂대 쟾떖빐 以떎뒗 젏뿉꽌 빟븳 ABO 븘삎 寃異쒖뿉 븳 以묒슂꽦씠 뜑 媛뺤“맆 븘슂媛 엳떎.

D 蹂씠삎 以 遺遺 D뒗 떆빟뿉 뵲씪 쓳吏묐컲쓳쓽 쑀臾닿 떖씪吏 닔 엳쑝誘濡 D 蹂씠삎 寃泥댁쓽 RhD 삁븸삎寃궗뒗 룊媛뿉 룷븿븯吏 븡븯떎. 2017뀈 D 蹂씠삎 寃泥댁 2018뀈 1李 寃泥대뒗 RhD 삁븸삎寃궗뿉꽌 젙긽 D 뼇꽦뿉 鍮꾪빐꽌뒗 빟븯吏留 쓳吏묒쓣 蹂댁씤 D 蹂씠삎 寃泥댁떎. 씠윭븳 寃泥대뱾 RhD 삁븸삎 寃궗뿉꽌 D빆썝씠 씠誘 寃異쒕릺뿀쑝誘濡 weak D寃궗瑜 떆뻾븯吏 븡怨 ‘not done’쑝濡 蹂닿퀬븳 湲곌뱾룄 쟻빀쑝濡 룊媛븯떎. 씠윭븳 寃泥대 D 蹂씠삎쑝濡 蹂닿퀬븳 湲곌쓽 鍮꾩쑉 2017뀈룄 51.7%, 78.7% 洹몃━怨 2018뀈 1李 寃泥대뒗 젙떟瑜좊줈 룊媛븳 80.9%濡 2017뀈 1李 寃泥댁뿉 鍮꾪븯뿬 李몄뿬湲곌뱾쓽 D 蹂씠삎 뙋젙瑜좎씠 利앷븯쓬쓣 븣 닔 엳뿀떎. 諛섎㈃ 2018뀈 2李 寃泥대뒗 weak D寃궗뿉꽌룄 쓬꽦쓣 蹂댁씠뒗 湲곌뱾씠 63.6%瑜 蹂댁씪 留뚰겮 빟븳 D빆썝쓣 媛吏 D 蹂씠삎쑝濡 李몄뿬湲곌쓽 빀쓽瑜 룄異쒗븯吏 紐삵븯뿬 룊媛뿉꽌 젣쇅븯뒗뜲, 異붽寃궗濡 weak partial 15씠 쓽떖릺뿀뜕 寃泥댁떎. 援젣닔삁븰쉶쓽 RH 由 쑀쟾옄 紐낅챸 媛씠뱶씪씤뿉 쓽븯硫 partial D삎 빆썝 寃곗젙湲곗쓽 씪遺媛 냼떎릺뼱 빆-D 빆泥대 쑀諛쒗븳 쐞뿕씠 엳뒗 삁븸삎씤 諛섎㈃ weak D삎 씪遺 삁쇅瑜 젣쇅븯怨좊뒗 빆썝 寃곗젙湲곗쓽 냼떎씠 뾾쑝誘濡 빆-D 빆泥 쑀諛 쐞뿕씠 뾾뒗 삁븸삎쑝濡 紐낅챸븯뒗뜲, 씠 삁쇅洹쒖젙뿉 빆-D 빆泥대 쑀諛쒗븳 쐞뿕씠 엳뒗 weak D삎쓣 weak partial D삎쑝濡 紐낅챸븯떎[5]. Weak D 삎 以 type 11, 15 21뱾 뿬湲곗뿉 냽븯硫 씠뱾 떎뼇븳 빆썝 寃곗젙湲곗쓽 蹂삎쑝濡 빆-D 빆泥대 깮궛븷 닔 엳뒗 寃껋쑝濡 븣젮졇 엳떎[6,7]. 씠윭븳 weak partial D삎 떎瑜 D 蹂씠삎 寃泥댁뿉 鍮꾪븯뿬 D빆썝씠 븯릺뼱 엳쓣 肉먮쭔씠 븘땲씪 씪遺 빆썝 寃곗젙湲곌 냼떎릺뿀쑝誘濡 weak D寃궗뿉꽌룄 쓬꽦쓣 蹂댁씪 닔 엳寃좎쑝굹 뿄삁옄瑜 鍮꾨’븯뿬 떊깮븘 궛紐⑥뿉꽌뒗 諛섎뱶떆 寃異쒗븯뿬빞 븳떎뒗 젏뿉꽌 D 쓬꽦쑝濡 蹂닿퀬븳 湲곌뱾쓽 weak D寃궗쓽 젏寃씠 븘슂븯寃좊떎.

ABO 빆泥 뿭媛寃궗踰 以 떆뿕愿踰 떎삩諛곗뼇씠 삁뀈泥섎읆 젙떟瑜좎씠 媛옣 넂븯뒗뜲, 삁뀈뿉뒗 썝二쇱쓳吏묐쾿씠 떆뿕愿踰뺤뿉 鍮꾪븯뿬 젙떟瑜좎씠 넂븯뜕 諛섎㈃ 湲덈뀈뿉뒗 떆뿕愿踰뺤씠 뜑 넂 뼇긽쓣 굹궡뿀떎.

2018뀈뿉뒗 李몄뿬湲곌 닔媛 쟾뀈룄뿉 鍮꾪븯뿬 룊洹 10.5% 뜑 利앷븯쑝硫, 삁뀈怨 留덉갔媛吏濡 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.

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