Frequency and causes of blood chimera in combat trauma victims

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Abstract

The frequency and causes of blood chimeras in victims of combat trauma who arrived from special military operations were analyzed. Data from immunohematological studies of patients admitted to the clinics of the Military Medical Academy named after S. M. Kirov in the period from February to December 2022 were analyzed. All patients were assessed for blood group membership by AV0 systems and Rh factor with phenotyping of erythrocytes and the presence of antierythrocyte antibodies. Chimerism was found in 21% of the patients. According to the AB0 system, general chimerism was detected in 3. 1% of cases, whereas blood chimerisms for antigens A and B were found in 81. 8% and 36. 4% of the cases, respectively. Moreover, blood chimerism for antigens C, c, E, and e was detected in 100% of the cases, and for antigen D, the rate of chimerism was 7. 6%. The identified chimerism in the patients was caused by the use of “universal” doses of erythrocyte blood components by advanced medical service units. In general, the frequency of blood chimerism in victims of combat trauma in the clinics of the Military Medical Academy named after S. M. Kirov was 21%. Blood chimerism in combat trauma victims did not lead to significant immunization. Despite the absence of detected immunization, blood chimerism was a favorable background for possible hemolytic posttransfusion complications during treatment. Possible options for the prevention of blood chimerism include the introduction into practice of advanced use of artificial oxygen carriers, active use of hardware support for reinfusion of blood spilled into the cavity, and preparation of autokrovi for certain patients. These measures are aimed at reducing the number of transfusions of donor blood components, thereby preventing the formation of antierythrocyte antibodies and blood chimeras.

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About the authors

Кirill A. Tsygankov

Kirov Military Medical Academy

Author for correspondence.
Email: doctorcygankov@mail.ru
ORCID iD: 0000-0002-2357-0685
SPIN-code: 7133-0503

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Denis Yu. Gorban

Kirov Military Medical Academy

Email: doctorcygankov@mail.ru

residency student

Russian Federation, Saint Petersburg

Roman E. Lakhin

Kirov Military Medical Academy

Email: doctor-lahin@yandex.ru
ORCID iD: 0000-0001-6819-9691
SPIN-code: 7261-9985

MD, Dr. Sci. (Med.)

Russian Federation, Saint Petersburg

Aleksey V. Shchegolev

Kirov Military Medical Academy

Email: alekseishegolev@gmail.com
SPIN-code: 4107-6860

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

Lidiya P. Savelyeva

Kirov Military Medical Academy

Email: doctorcygankov@mail.ru

Head of the laboratory

Russian Federation, Saint Petersburg

Pavel P. Konoshenko

32-Separate Medical Detachment (airmobile)

Email: doctorcygankov@mail.ru

Head of the surgical Department

Russian Federation, Anapa

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Supplementary files

Supplementary Files
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2. Fig. 1. Frequency of blood chimerism depending on the number of incoming wounded by month

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3. Fig. 2. Structure of identified blood chimeras according to the AB0 system and Rh factor

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