Nuklearmedizin 1974; 13(03): 236-244
DOI: 10.1055/s-0038-1624861
Originalarbeiten — Original Articles
Schattauer GmbH

Prevention of Rh Immunization

Evaluation of Rho (D) Antibody and Elaboration of its Mechanism of Action by Chromium-51 RBC Clearing MethodDie Vorbeugung der Rh-ImmunisierungDie Auswertung von Rh0 (D)-Antikörpern und Untersuchungen über ihren Wirkungsmechanismus mit der Clearingmethode von 51Cr-markierten roten Blutkörperchen
G. T. Krishnamurthy
1   Nuclear Medicine Service, Veterans Administration Wadsworth Hospital Center and Department of Medicine, UCLA School of Medicine, Los Angeles, California
,
Joseph F. Ross
1   Nuclear Medicine Service, Veterans Administration Wadsworth Hospital Center and Department of Medicine, UCLA School of Medicine, Los Angeles, California
,
William H. Blahd
1   Nuclear Medicine Service, Veterans Administration Wadsworth Hospital Center and Department of Medicine, UCLA School of Medicine, Los Angeles, California
› Author Affiliations
Further Information

Publication History

Received:24 June 1974

Publication Date:
15 January 2018 (online)

Summary

Four-hundred-and-fifty µgm of Rh0(D) antibody given I.M. 24 hours before transfusion of 2 ml of Rh-positive into Rh-negative ABO compatible recipient, causes rapid removal of the transfused cells. Fifty percent of the injected RBCs disappeared from the circulation with a mean T-V2 of 8 minutes (range 4-12 min). N o circulating donor RBCs were detected in the peripheral blood 4 hours after transfusion. The destruction of trapped 51Cr-labelled cells occurs over a three-day period primarily in the liver and spleen, presumably in the reticuloendothelial cells. Once trapped in the reticuloendothelial system, intact cells do not re-enter the circulation. Chromium-51 liberated after destruction of RBCs enters the plasma and is rapidly eliminated in the urine. No untoward reaction either local or systemic occurred after intramuscular injection of Rh0(D) antibody. Clinical trials to determine the minimum effective dose of antibody for routine and "high risk" group are needed but it is likely to be well below the dose of 450 µgm used in this study.

450 μg Rh0 (D)-Antikörper intramuskulär 24 Stunden vor Transfusion von 2 ml Rh-positiven Blutes auf Rh-negative ABO-kompatible Empfänger führt zu einer raschen Entfernung der transfundierten Zelle. 50% der injizierten roten Blutkörperchen verschwanden aus dem Kreislauf mit einer mittleren T½ von 8 Minuten (Streuung 4—12 Minuten) . Keine zirkulierenden Spenderblutkörperchen konnten im peripheren Blut 4 Stunden nach der Transfusion gefunden werden. Die Zerstörung der gebundenen 51Cr-markierten Zellen erfolgt in einer dreitägigen Zeitspanne vorwiegend in Leber und Milz, vermutlich in den RES-Zellen. Intakte Blutkörperchen, die einmal im RES eingefangen sind, gelangen nicht wieder in die Zirkulation. 51Cr, das nach der Zerstörung der Blutkörperchen frei wird, gelangt in das Plasma und wird schnell im Urin ausgeschieden. Es wurde keine unerwünschte Reaktion weder lokal noch allgemein nach intramuskulärer Injektion von Rh0 (D)-Antikörper beobachtet. Klinische Studien zur Bestimmung der minimal wirksamen Antikörperdosis für Routine- und Risiko-Gruppen sind noch erforderlich, doch liegen diese vermutlich erheblich niedriger als die 450 μg, die in dieser Studie verabreicht wurden.

 
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