WS 203: Evolution and historical versions
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Basic data | Standard ID | WS 203-2020 (WS203-2020) | | Description (Translated English) | (Transfusion Medicine Terminology) | | Sector / Industry | Health Industry Standard | | Classification of Chinese Standard | C50 | | Date of Issue | 2020-11-01 | | Date of Implementation | 2020-11-01 | | Older Standard (superseded by this standard) | WS/T 203-2001 | | Regulation (derived from) | State-health communication (2020) No. 7 | | Issuing agency(ies) | National Health Commission | WS/T 203-2020: (Transfusion Medicine Terminology)---This is a DRAFT version for illustration, not a final translation. Full copy of true-PDF in English version (including equations, symbols, images, flow-chart, tables, and figures etc.) will be manually/carefully translated upon your order.
Terminology for transfusion medicine
ICS 11.020
C 50
WS
People's Republic of China Health Industry Standard
Replace WS/T 203-2001
Medical terms for blood transfusion
2020-04-23 release
2020-11-01 implementation
Issued by the National Health Commission of the People's Republic of China
Table of contents
Foreword...II
1 Scope...1
2 Basic terminology...1
3 Terms related to basic blood transfusion...2
4 Terms related to blood donation service...11
5 Terms related to blood transfusion technology...13
6 Terms related to clinical transfusion...18
7 Terms related to angiography...25
Index...29
Foreword
This standard was drafted in accordance with the rules given in GB/T 1.1-2009.
This standard replaces WS/T 203-2001 "Terms of Common Use in Blood Transfusion Medicine".
Compared with WS/T 203-2001, the main changes of this standard are as follows.
--Adjusted the content structure of the standard, according to the GB/T issued by the National Standardization Administration in July.2016
13745-2009 "Discipline Classification and Code" National Standard No. 2 Announcement, which divides the terms of this standard into basic terms,
There are 6 chapters in basic blood transfusion, blood donation service, blood transfusion technology, clinical blood transfusion and vascular science. The terms in each chapter are in accordance with
The logical and progressive relationship of the concepts;
--In order to facilitate the quotation and reference of this standard by other regions that use Chinese, some specific terms are expressed in the form of "notes".
Names of other Chinese regions, such as voluntary unpaid blood donors are called blood donors in Hong Kong, Macao and Taiwan;
--Add some foreign terms that have appeared in the practice of blood transfusion medicine in recent years, reflecting the latest development level of domestic blood transfusion medicine, such as
Blood donor shielding, regional joint shielding, nucleic acid testing revenue, patient blood management and blood safety monitoring, etc.;
- Delete the terms that do not have specific meanings in the blood transfusion industry, such as blood; delete other industries that have been clear, this standard uses
Terms that the user should quote directly, such as antigen, antibody, etc.; deleted some of the terms that belong to this standard, but the concept is obvious
Terms that are not easy to cause misunderstanding or ambiguity, such as preoperative blood sampling, blood storage refrigerator and blood bag, etc.;
--It is one of the principles of the revision of this standard to be consistent with other current domestic blood transfusion standards as much as possible, but there are discrepancies in other standards.
Definitions, or terms that are inconsistent with international consensus, are revised and improved in the form of "notes" in this standard;
--This standard does not include terms related to hematopoietic stem cells and plasma-derived products;
-Increase the Chinese and English index of terms, Chinese terms are arranged in alphabetical order of Hanyu Pinyin, and English terms are arranged in alphabetical order.
Drafting organizations of this standard. Shanghai Blood Center, Beijing Red Cross Blood Center, Zhejiang Blood Center, Chinese Academy of Medical Sciences
Blood Research Institute, Chinese People's Liberation Army General Hospital, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology.
The main drafters of this standard. Zhu Yongming, Gong Yuchun, Wang Hongjie, Lin Junjie, Liu Jiaxin, Lu Hangjun, Wang Deqing, Hu Lihua, Xu Zhong,
Wang Naihong.
The previous versions of the standard replaced by this standard are as follows.
--WS/T 203-2001.
Medical terms for blood transfusion
1 Scope
This standard defines the normative terms and their meanings of commonly used management and technical terms in domestic blood transfusion medicine.
This standard is applicable to the quotation and interpretation of common terms used in blood transfusion in domestic blood transfusion medicine and related fields.
2 Basic terms
2.1
Transfusion medicine
An important part of clinical medicine. Mainly research the basic theories related to blood and blood transfusion, blood immune mechanism and clinical treatment, technology
Application and expansion of blood donation, blood donation service and blood quality, component transfusion and blood product application, prevention and treatment of blood-borne diseases, information
In order to achieve scientific, safe, effective and accessible blood transfusion, research and promote new blood transfusion technology.
Note 1.In July.2016, blood transfusion medicine was approved as a secondary discipline by the National Standardization Management Committee.
Note 2.Under the "Transfusion Medicine", three-level disciplines "Basic Transfusion, Blood Donation Service, Blood Transfusion Technology, Clinical Blood Transfusion, Vascular Transfusion and Blood Transfusion" are established
Other disciplines of medicine".
2.1.1
Basic transfusion medicine
Mainly include blood transfusion immunohematology, blood group genetics, human leukocyte antigen, transfusion-transmitted diseases, blood substitutes and communication
Research with blood etc.
2.1.2
Science of blood donation service
It mainly includes the promotion of unpaid blood donation, the recruitment of blood donors, the establishment of a blood donor bank of rare blood types, consultation, management, nursing and services, etc.
And follow-up related supporting services in all aspects.
2.1.3
Transfusion technology
Mainly include blood collection, separation and preparation technology (including apheresis technology and hematopoietic stem cell preparation); blood transfusion-transmitted disease detection technology;
White blood cell removal technology; blood irradiation technology; virus inactivation technology; blood cryopreservation technology; blood freeze-drying technology; blood transfusion compatibility test
Technology; platelet matching technology; tissue matching technology; blood transfusion-related thrombosis and hemostasis detection technology; blood preservation and transportation technology.
2.1.4
Clinical transfusion medicine
It mainly includes the application of whole blood, blood components, and blood products; clinical indications and contraindications for blood transfusion; pre-transfusion evaluation and post-transfusion efficacy evaluation;
Blood transfusion care; adverse blood transfusion reactions and prevention; blood transfusion-related cell therapy; application of transfusion-related genetic engineering products; plasma exchange and apheresis
Treatment; blood transfusion treatment of fetal or neonatal hemolytic disease and autologous blood transfusion.
2.1.5
Transfusion management
Vascular transfusion includes blood station management and clinical blood transfusion management. Management at blood stations includes general blood station management and special blood station management; at blood stations
Quality management and blood station laboratory quality management include organization management, resource management, business process management and program management; blood station information management
Wait. Clinical blood transfusion management includes clinical blood management and blood transfusion department (hospital blood bank) management, including organization management, resource management, and blood transfusion treatment
Whole process quality management, blood transfusion laboratory management, blood transfusion laboratory quality management, blood management, teaching training and scientific research management, blood transfusion ethics law
Learning management and information management, etc.
2.2
Hospital blood bank
Department of transfusion medicine
Set up by medical institutions, responsible for clinical blood storage and distribution, and medical blood business guidance. The main responsibilities are. to establish clinical
The blood quality management system promotes the rational use of blood in clinical practice; is responsible for formulating the clinical blood reserve plan, based on the early warning information of blood supply from the blood station and the hospital
Coordinating clinical blood use in the blood inventory; responsible for blood booking, warehousing, storage, and distribution; responsible for blood transfusion-related immunohematology testing;
Participate in the promotion of autologous blood transfusion and other blood protection and new blood transfusion technologies; participate in the consultation of special blood transfusion treatment cases, and provide consultation for the clinical rational use of blood;
Participate in the investigation of adverse events of clinical blood use; participate in the development of blood treatment related technologies according to the needs of clinical treatment; undertake the tasks assigned by medical institutions
Other tasks related to clinical use of blood.
3 Related terms in basic blood transfusion
3.1 Immunohematology
3.1.1
Blood group
Any genetic polymorphism that can be detected in the blood can be called blood type, but blood type is usually limited to the polymorphism of blood cell surface antigen
Sex, including red blood cell, platelet and neutrophil blood types. In unspecified cases, the blood type generally refers to the red blood cell type.
3.1.2
Blood group typing
Confirm the antigen specificity of genetic polymorphism on blood cells.
3.1.3
Recalcification of plasma
By adding enough calcium ions so that the original anticoagulant plasma containing citric acid or citrate anticoagulant such as ACD, CPD, etc., was added, the internal
Acquired blood coagulation ability.
3.1.4
Collection
A set of antigens that are related to genetics, biochemistry, or serology, but have not yet reached the blood group system standards, that is, the.200 series. usually
The genes that determine the antigen have not yet been determined.
3.1.5
High-prevalence antigen series
The frequency of red blood cell antigens is greater than 99% in the population and does not belong to any blood group system and collection. It is called the high-frequency antigen series, that is, the 901 series.
3.1.6
Low-prevalence antigen series
The frequency of red blood cell antigens is less than 1% in the population, which is not suitable for any blood group system or collection. It is called the low-frequency antigen series, that is, the 700 series.
3.1.7
Red cell group system
Classification according to the genetic relationship of red blood cell surface antigens. Not controlled by 1 locus or 2 to 3 loci with the same function
The blood group antigens encoded or determined by the alleles belong to the same blood group system. Some blood group system genes directly encode blood group antigens
The protein where the cluster is located, and some other blood group system antigens are carbohydrates, and blood group genes encode glycosyltransferases that catalyze the formation of these antigens.
to make.
3.1.7.1
Agglutination
Antibody molecules bridge between adjacent cell surface epitopes, causing them to form granular clumps visible to the naked eye.
3.1.7.2
Pseudo-agglutination
Granular aggregation of cells caused by non-antigen antibody binding.
3.1.7.3
Rouleaux formation
When using plasma expanders and abnormal plasma proteins, the red blood cells appear to be superimposed pseudo-agglutination under the microscope.
3.1.7.4
Cold-reactive agglutination
Agglutination of red blood cells caused by cold antibodies.
3.1.7.5
Naturally occurring antibody;natural antibody
Blood group antibodies that appear in the blood without obvious immune stimulation such as blood transfusion or pregnancy.
3.1.7.6
Unexpected antibody
Anti-A and anti-B blood group antibodies in the normal ABO blood group. Unexpected antibodies were once called irregular antibodies.
3.1.7.7
Red cell reagent panel
Used for accidental antibody identification, a selected group of red blood cells containing type O reagents with different antigen distributions. The reagent red blood cell group was once called
It is panel cells.
3.1.7.8
A antigen
N-acetylgalactosamine (GalNAc) attached to the carbon 3 position of the fucosylated terminal galactose residue of substance H is the A antigen
The immunodominant monosaccharide shows the activity of A antigen.
3.1.7.9
B antigen B antigen
D-galactose (Gal) attached to the carbon 3 position of the fucosylated terminal galactose residue of substance H is the immunodominance of B antigen
Monosaccharide, showing the activity of B antigen.
3.1.7.10
H antigen
The blood group precursor substance terminal galactose first connects a L-fucose (Fuc) at the carbon 2 position to form H antigen, and the L-fucose residue is H
The immunodominant monosaccharide of antigen, H antigen is the basis for the formation of A and B antigens.
3.1.7.11
Anti-A anti-A
Only antibodies that agglutinate with antigen A.
3.1.7.12
Anti-B anti-B
Only antibodies that agglutinate with B antigen.
3.1.7.13
Landsteiner's rule
In the ABO blood group system, individuals over 4 to 6 months of age have plasma or serum containing A and B antigens that are lacking in their own red blood cells
Of antibodies.
3.1.7.14
ABO blood group determination
Detect the A antigen and B antigen on the surface of the red blood cell membrane with positive and reverse typing reagents, as well as anti-A and anti-B antibodies in serum or plasma,
Judge ABO blood type through positive and negative stereotypes results.
3.1.7.14.1
Forward type
Cell grouping
Use anti-A and anti-B blood group antibodies to detect the presence of A antigen and B antigen on the surface of the red blood cell membrane to determine the blood group.
3.1.7.14.2
Reverse type
Serum grouping
Use A1 and B red blood cells to detect the presence of anti-A and anti-B antibodies in serum or plasma to determine the blood type.
3.1.7.14.3
Subgroup
According to the serological characteristics of ABO stereotypes and the characteristics of blood group substances in saliva, type A and type B can be further divided into subgroups of A (subgroup of
A) and subgroup of B.
The A subtypes mainly include A1, Aint, A2, A3, Ax, Am and so on. The most common A subtypes are A1 and A2.In addition, A type also includes A antigen weak table
Up to the phenotype.
B subtypes mainly include B3, Bx, Bm and so on.
3.1.7.14.4
Cis AB type CisAB group
Usually A antigen and B antigen are determined by a pair of alleles, and the characteristics of A and B antigens of cis AB blood group are determined by the same allele.
The genetic characteristics of A and B antigens on red blood cells do not separate with the separation of alleles.
3.1.7.15
Bombay phenotype
The non-secreted type lacking H antigen is called Bombay type (Oh). Although it has the normal ABO gene, A and B are not expressed on the red blood cell membrane
There are no A, B and H blood group substances in secretions such as H antigen and saliva. The serum contains anti-A, anti-B and anti-H antibodies.
3.1.7.16
Para-Bombay phenotype
The secretory type lacking H antigen is called the Bombay-like type. The ABO gene is normal, there is no H antigen on the red blood cell membrane, but a small amount of A and/or B can be detected
Antigens, saliva and other secretions contain ABH blood group substances. Different Bombay-like phenotypes, serum contains anti-A and/or anti-B antibodies and weak anti-H
antibody.
3.1.7.17
Rh blood group system
The No. 4 blood group system named by the International Blood Transfusion Association is also the most complex blood group system, with high immunogenicity and complex polymorphism
Sex, the clinical importance of blood transfusion medicine is second only to the ABO system. The antigens of the Rh blood group system are encoded by the RHD gene and the RHCE gene.
3.1.7.17.1
Rh antigen
The Rh blood group system currently has 54 antigens (numbers RH1 to RH61, 7 of which are obsolete), all of which are derived from RHD genes and RHCE
Gene coding (respectively express RhD (CD240D) and RhCcEe (CD240CE) proteins). Most of the clinically important antibodies in the Rh system
It targets the five main antigens (D, C, c, E, e).
3.1.7.17.2
Rh haplotype
Haplotype refers to a combination of alleles or genetic markers on a homologous chromosome. The Rh system has eight main haplotypes, divided into
Don't be DCe, dce, DcE, Dce, dcE, dCe, DCE, dCE, where d represents the RHD gene that is missing or incomplete.
3.1.7.17.3
Rh phenotype
Through serological tests, the identification of the presence or absence of certain antigens on red blood cells is called phenotype. Use anti-D, anti-C, anti-c, anti-E and anti-e,
18 phenotypes of Rh system can be distinguished.
3.1.7.17.4
D antigen
Encoded by the RHD gene, a specific membrane protein antigen on human red blood cells that can only be recognized by anti-D.
The surface of red blood cells carries normal RhD protein, or weak D, partial D and Del phenotypes caused by D antigen variation are called Rh positive (RhD
positive).
The deletion or inactivation mutation of RHD gene causes the deletion of D polypeptide on the red blood cell membrane, resulting in the deletion of all D epitopes, which is called Rh negative
(RhD negative).
3.1.7.17.5
RhD typing
Use anti-D typing reagents to detect the presence of D antigen on the surface of red blood cells.
3.1.7.17.5.1
RhD initial typing
Use the IgM anti-D blood group antibody in the Rh blood group typing reagent to react with red blood cells in saline medium, and use the direct agglutination test to detect red blood cells
Whether there is D antigen on the cell.
3.1.7.17.5.2
Rh negative confirmation confirmatory test for Rh negative
Confirm Rh negative by excluding weak D.
3.1.7.17.6
Weak D
A phenotype with reduced D antigen expression.
3.1.7.17.7
D variant
The quantitative or qualitative change of D antigen is called D variant, which can be divided into weak D and partial D.
3.1.7.17.8
Del phenotype
Del red blood cells express very low levels of D antigen. Conventional serological methods cannot detect the Del phenotype. Red blood cells of this phenotype can absorb and release
Sankang D. 10% to 30% of D-negative individuals in the Asian population have the Del phenotype.
3.1.7.17.9
Part D partial D
Red blood cells lack a part of the phenotype of D antigen epitope, which is manifested as a change in the nature of D antigen. Some part D is also "weak D", namely
This is accompanied by a decrease in the number of D antigens.
3.2 Leukocyte Antigen System
3.2.1
Major histocompatibility complex; MHC
A group of genes that encode proteins related to antigen presentation and cell-to-cell recognition, and sometimes also represents the molecules that this group of genes encode and express
Or a complex composed of antigens, which mainly controls the body’s reactivity against foreign tissues or organs, and is closely related to tissue organ transplant rejection.
It is called the HLA complex and is located on the short arm of human chromosome 6.MHC is divided into three regions, namely MHC-I, II, and III regions.
3.2.1.1
MHC class I region
Located near the telomere of the short arm of chromosome 6, it mainly includes HLA-I genes, divided into HLA-A, B, C, E, F, G, MICA, MICB
Etc., among which HLA-A, B, C are called classical HLA-I genes, which encode and express the heavy chains of MHC I molecules. HLA-E, F, G, etc. are
Classical HLA-I genes, there are several genes with unknown functions in this region.
3.2.1.2
MHC class II region
Located at the centromere end of the short arm of chromosome 6, it mainly includes HLA-II genes, divided into HLA-DRB1, -DRB3/4/5, -DQA1,
-DQB1, -DPA1, -DPB1, -DOA, DOB, -DMA, -DMB, etc., respectively encode the α or β chain of the molecule of the same name in MHC class II molecules.
3.2.1.3
MHC class III region
Located between the MHC-I and MHC-II regions, it contains a series of genes that encode certain serum complement components, heat shock proteins,
Tumor necrosis factors, such as human C2, Bf, C4A, C4B, etc., do not participate in the composition of HLA antigens, and do not participate in antigen presentation, but are related to immune responses.
3.2.2
Minor histocompatibility antigen; mHag
There are some mismatched tissue antigens between the donor and recipient, which can induce MHC restricted killer T cells when the donor and recipient’s MHC are completely matched
Reaction or proliferation, causing rejection, these tissue antigens can be sex-linked or non-sex-linked. More explicit sex
The unlinked mHag has HY, and the non-sex linked mHag has HA-1～-5.
3.2.3
Human leucocyte antigen; HLA
A glycoprotein antigen shared or partially shared by human tissue cells, divided into HLA-I antigens and HLA-II antigens; HLA-I antibodies
The original can be expressed on the surface of many nucleated cells; HLA-II antigens can be expressed on the cell membranes of B cells, activated T cells, and antigen-presenting cells.
3.2.3.1
HLA class I antigen
MHC class I molecule
Mainly divided into HLA-A, B, C antigens, each antigen is composed of a transmembrane α chain and a free β chain, the α chain 44Kd, with
Polymorphism, β chain 12Kd, no polymorphism. HLA-I antigens present endogenous antigen peptides and are recognized by CD8-positive T cells.
3.2.3.2
HLA class II antigen
MHC class II molecule
It is encoded and expressed by HLA-II genes, and is mainly divided into HLA-DR, -DQ, -DP antigens, etc. Each antigen consists of an α chain (34KD) and a
It is composed of a β chain (29Kd), which recognizes and presents exogenous antigen peptides to CD4 positive T cells.
3.2.4
Lymphocyte microcytotoxicity test; LCT
A method of detecting HLA antigen on the surface of lymphocytes. The corresponding antibody binds to the antigen to form a membrane attack complex in the presence of complement to kill
Damage to lymphocytes, causing lymphocytes to swell and die. This test is also called complement-dependent cytotoxicity test (complement-dependent
lymphocytotoxicity test; CDC).
3.2.5
Mixed lymphocyte culture;MLC
Mixed lymphocyte reaction; MLR
It is often used for tissue matching before organ transplantation to determine the degree of compatibility between the recipient and the donor's major histocompatibility antigen (HLA antigen). If
One-way mixed lymphocyte culture is called one-way mixed lymphocyte culture (one-way mixed lymphocyte) after the lymphocytes of one party (usually the donor) are inactivated.
culture).
3.2.6
Histocompatibility typing
Histocompatibility matching
In order to successfully carry out allogeneic organ or tissue cell transplantation, a series of tests, including the HLA antigen typing of the donor and recipient,
Cross-match between donors and recipients to identify clinically relevant antibodies against the donor, and continuously monitor the recipient’s humoral immune status to monitor for HLA antibodies
Body production, and ABO blood typing between donors and recipients.
3.2.7
Allelic resolution typing
The nucleotide sequence obtained by the DNA typing method used conforms to a certain allele defined by the WHO HLA Nomenclature Committee.
3.2.8
High resolution typing
The DNA typing method has obtained a set of alleles, which have been clearly coded for the amino group of the antigen binding site domain on the HLA molecule.
Acid sequence, and has excluded alleles that are not expressed on the cell surface. The antigen binding site domain includes the α1 on the α chain of the class I antigen.
The α2 domain, the α1 domain of the α chain of the class II antigen, and the β1 domain of the β chain.
3.2.9
Low resolution typing
The result obtained by DNA typing method is only equivalent to the specificity corresponding to the first region of allele naming, and is similar to the equivalent of serological typing results.
3.2.10
P code
It is formulated by the WHO HLA Nomenclature Committee to report a group of indistinguishable HLA typing results, which is characterized by all HLA alleles in the group
Because they all encode the same antigen-binding site domain, use a capital P letter directly after the allele name with the smallest value in the group naming,
For example, A*02.05P, represents A*02.05.01/A*02.05.02/A*02.05.03/A*02.05.04/A*02.05.05/A* 02.05.06/
A*02.179/A*02.324 this group.
3.2.11
G code
It is formulated by the WHO HLA Nomenclature Committee to report a group of indistinguishable HLA typing results, which is characterized by all HLA alleles in the group
Because they have the same exon nucleotide sequence encoding the domain of the antigen binding site, use a capital ...
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