TÜRK KIZILAY

İMMÜNOHEMATOLOJİ LABORATUVARIRUTİN UYGULAMALARI

Uzm.Dr. Özgür R┑ズデ┑ GÜNERL;Hﾗヴ;デ┌┗;ヴ Bｷヴｷﾏ YﾜﾐWデｷIｷゲｷ

güvenilir ve uygun nitelikte kan HｷﾉWズWﾐｷ

AMAÇ い

İﾏﾏ┑ﾐﾗﾉﾗﾃｷﾆ SWヴﾗﾉﾗﾃｷﾆ

PREANALİTİK SÜREÇTE たONLINEだ

DONASYON YÖNETİMİ

PREANALİTİK SÜREÇTE たONLINEだ

DONASYON YÖNETİMİ

Eﾆｷヮ Sﾗﾆデﾗヴ┌ﾐ┌ﾐ SWｬWヴﾉWﾐSｷヴﾏWゲｷ ゲﾗﾐヴ;ゲﾀﾐS; Sﾗﾐ;ゲ┞ﾗﾐ ｷNｷﾐ ┌┞ｪ┌ﾐ ﾗﾉS┌ｬ┌ﾐ; ﾆ;ヴ;ヴ ┗WヴｷﾉWﾐ H;ｬﾀズNﾀﾉ;ヴ; H;ヴﾆﾗSﾉ┌ HｷﾉWﾆﾉｷﾆﾉWヴｷ デ;ﾆﾀﾉﾀヴく

Dﾗﾆデﾗヴ ﾗﾐ;┞ﾀ ゲﾗﾐヴ;ゲﾀ ;┞ﾐﾀ ISBT H;ヴﾆﾗS ﾐ┌ﾏ;ヴ;ゲﾀﾐ; ゲ;ｴｷヮ デWゲデ デ┑ヮﾉWヴｷが デﾗヴH; ゲｷゲデWﾏﾉWヴｷ ┗W H;ｬﾀズNﾀ┞; ;ｷデ aﾗヴﾏﾉ;ヴ Hｷヴ

;ヴ;┞; ｪWデｷヴｷﾉｷヴく

T┑ヮﾉWヴっTﾗヴH; ゲｷゲデWﾏﾉWヴｷが aﾗヴﾏﾉ;ヴが HｷﾉWﾆﾉｷﾆ ┗W aﾉWHﾗデﾗﾏｷゲデｷﾐ ﾆWﾐSｷ ﾆｷﾏﾉｷﾆ H;ヴﾆﾗS┌ Wﾉ デWヴﾏｷﾐ;ﾉｷﾐSW

WズﾉWズデｷヴｷﾉﾏWSWﾐ Sﾗﾐ;ゲ┞ﾗﾐ ﾗﾐﾉｷﾐW ﾗﾉ;ヴ;ﾆ ゲﾗﾐﾉ;ﾐSﾀヴﾀﾉ;ﾏ;┣く

Dﾗﾐ;ゲ┞ﾗﾐ┌ﾐ H;ズﾉ;ﾐｪﾀNが Hｷデｷズ ゲ;;デｷ ┗W ;ﾉﾀﾐ;ﾐ ｴ;Iｷﾏ Hｷﾉｪｷゲｷ ｪｷHｷ ┗WヴｷﾉWヴ SW Wﾉ デWヴﾏｷﾐ;ﾉｷﾐW ﾆ;┞SWSｷﾉｷヴWヴWﾆ HWﾏﾗﾐﾉｷﾐWゲｷゲデWﾏｷﾐW ;ﾆデ;ヴﾀﾉﾀヴく

N┌ﾏ┌ﾐWﾉWヴが H┌ ｷズ ｷNｷﾐ デ;ゲ;ヴﾉ;ﾐﾏﾀズ ┗W ﾆ;ﾉｷaｷﾆ;ゲ┞ﾗﾐ┌ ┞;ヮﾀﾉﾏﾀズ デヴ;ﾐゲヮﾗヴデ ﾆ┌デ┌ﾉ;ヴﾀﾐS; ┌┞ｪ┌ﾐ ﾆﾗズ┌ﾉﾉ;ヴS; ﾉ;Hﾗヴ;デ┌┗;ヴ; ┌ﾉ;ズﾀヴく

S;ﾐデヴｷa┑ﾃ ｷズﾉWﾏｷ

PヴW;ﾐ;ﾉｷデｷﾆ Iｷｴ;┣

K;ﾐ ｪ┑┗Wﾐﾉｷｬｷ ｷNｷﾐ asgari ﾆﾗズ┌ﾉﾉ;ヴﾀ ゲ;ｬﾉ;┞;ヴ;ﾆ デヴ;ﾐゲa┑┣┞ﾗﾐ ヴW;ﾆゲｷ┞ﾗﾐﾉ;ヴﾀﾐﾀ Wﾐ ;┣ S┑┣W┞W ｷﾐSｷヴﾏWﾉｷ┞ｷﾏが

ﾆﾗズ┌ﾉﾉ;ヴﾀﾏﾀ ｪWﾉｷズデｷヴSｷﾆNW ﾆ;ﾐ HｷﾉWズWﾐｷ ﾆ;ﾉｷデWゲｷﾐｷ ┗W ｪ┑┗Wﾐﾉｷｬｷﾐｷ S;ｴ; S; ;ヴデﾀヴ;I;ﾆ ┞Wﾐｷ ┌┞ｪ┌ﾉ;ﾏ;ﾉ;ヴ; ｪWNﾏWﾉｷ┞ｷﾏぁ

HWﾏﾗﾉｷデｷﾆ rW;ﾆゲｷ┞ﾗﾐﾉ;ヴﾀﾐ bir ﾆﾀゲﾏﾀﾐﾀ WﾐｪWﾉﾉW┞WHｷﾉｷヴｷﾏ

B;ｬﾀズNﾀﾉ;ヴS;き• Kan grubu デ;┞ｷﾐｷき ABOっRｴD• BWﾆﾉWﾐﾏW┞Wﾐ Aﾐデｷﾆﾗヴﾉ;ヴﾀﾐ

tespiti

Rｴ subgrupve

Kell AﾐデｷﾃWﾐ tayini

Dﾗﾐﾜヴ ｴ;┗┌┣┌ﾐ┌ gWﾉｷズデｷヴWヴWﾆ zﾗヴ bulunan kan gヴ┌ヮﾉ;ヴﾀﾐﾀ tWS;ヴｷﾆ

WSWHｷﾉｷヴｷﾏ

GWﾉWIWﾆデWGWﾐﾗデｷヮﾉWﾐSｷヴﾏW

L;Hﾗヴ;デ┌┗;ヴﾀ

Tヴ;ﾐゲa┑┣┞ﾗﾐ ﾜﾐIWゲｷ ｷﾏﾏ┑ﾐﾗｴWﾏ;デﾗﾉﾗﾃｷﾆ testler

ABO デｷヮﾉWﾐSｷヴﾏW

Rｴ デｷヮﾉWﾐSｷヴﾏW

Aﾐデｷﾆﾗヴ デ;ヴ;ﾏ;

Ç;ヮヴ;┣ ﾆ;ヴズﾀﾉ;ズデﾀヴﾏ;

Aﾐデｷﾆﾗヴ デｷヮﾉWﾐSｷヴﾏW

İﾉｪｷﾉｷ ;ﾐデｷﾃWﾐﾉWヴ ┞ﾜﾐ┑ﾐSWﾐ ﾐWｪ;デｷa

ﾆ;ﾐ HｷﾉWズWﾐｷ ゲWNｷﾏｷ

Ç;ヮヴ;┣ ﾆ;ヴズﾀﾉ;ズデﾀヴﾏ;TRANSFÜZYON

Pﾗ┣ｷデｷa

NWｪ;デｷa

UYGUN

UYGUN

%98 ﾗヴ;ﾐﾀﾐS; uygunluk

ゲ;ｬﾉ;ﾐﾏﾀズ ﾗﾉ┌ヴ

%2 ﾗヴ;ﾐﾀﾐS;

EK uygunluk

ゲ;ｬﾉ;ﾐﾏﾀズ ﾗﾉ┌ヴ

ERİTROSİT ANTİJENLERİNİN SAPTANMASINDA KULLANILAN YÖNTEMLER

1く HEMAGLÜTİNASYON

;く L;ﾏ ふSﾉｷSWぶ YﾜﾐデWﾏｷ

Hく T┑ヮ YﾜﾐデWﾏｷ

Iく JWﾉ S;ﾐデヴｷa┑ｪ;ゲ┞ﾗﾐ YﾜﾐデWﾏｷ

Sく Mｷﾆヴﾗヮﾉ;ﾆ YﾜﾐデWﾏｷ

2. RIA

3. EIA

4. PCR

16243 G2+16247 E6 A1 A2 A3 Ax Aw Abantu

Ah AmosAfinn cisAB Abadquirido

A3B AwB AbantuB A1B A2BAintAintB A3B

BIRMA-1 A1 A2 A3 Ax Aw AbantuA3B AwB A1B A2B

AintAintB A3B

Oriental(A2.Aint,AintB,A2B,A3B)

FARKLI KLONLARDAN ÜRETİLMİŞ MONOKLONAL Aﾐデｷ-A ANTİKORLARI わ FARKLI VARYANTLARLA REAKSİYON

5.6.1 K;ﾐ ｪヴ┌ヮﾉ;ﾏ;ゲﾀﾐS; ｴ┌ﾏ;ﾐ ┗W┞; ﾏﾗﾐﾗﾆﾉﾗﾐ;ﾉ ﾆ;┞ﾐ;ﾆﾉﾀ ｪヴ┌ヮﾉ;ﾏ; ヴW;ﾆデｷaﾉWヴｷ ﾆ┌ﾉﾉ;ﾐﾀﾉ;Hｷﾉｷヴ. Mﾗﾐﾗﾆﾉﾗﾐ;ﾉﾆ;ﾐ ｪヴ┌ヮﾉ;ﾏ; ヴW;ﾆデｷaﾉWヴｷﾐｷﾐ ﾆ┌ﾉﾉ;ﾐﾀﾏﾀ┞ﾉ; ゲデ;ﾐS;ヴデ Aが B ┗W D ;ﾐデｷﾃWﾐﾉWヴｷﾐｷﾐ ゲWﾐゲｷデｷ┗ｷデWゲｷ H┑┞┑ﾆ ﾗヴ;ﾐS; ;ヴデ;ヴ. AﾐI;ﾆ reaktifler Sｷﾆﾆ;デﾉｷ bir ズWﾆｷﾉSW ゲWNｷﾉﾏWSｷﾆﾉWヴｷ デ;ﾆSｷヴSW ┣;┞ﾀa D SW S;ｴｷﾉ ﾗﾉﾏ;ﾆ üzere H;┣ﾀ Aが B ┗W D ┗;ヴ┞;ﾐデﾉ;ヴﾀﾐﾀﾐ ゲ;ヮデ;ﾐﾏ;ゲﾀﾐS; ｴ;デ;ﾉ;ヴ ﾗﾉ;Hｷﾉｷヴ. ふUﾉ┌ゲ;ﾉ K;ﾐ ┗W K;ﾐ BｷﾉWズWﾐﾉWヴｷ RWｴく 2016が S;┞a; 263)

• K;ﾐ MWヴﾆW┣ﾉWヴｷﾐSW a;ヴﾆﾉﾀ ﾆﾉﾗﾐﾉ;ヴS;ﾐ ┑ヴWデｷﾉﾏｷズが H;ｬﾀﾏゲﾀ┣ ｷﾆｷ ABOっRｴ デWゲデｷ ﾆ┌ﾉﾉ;ﾐﾀﾏﾀ けゲデ;ﾐS;ヴデﾉ;ヴげ ;ヴ;ゲﾀﾐS; ┞Wヴ ;ﾉﾏ;ﾆデ;Sﾀヴ ふUﾉ┌ゲ;ﾉ K;ﾐ ┗W K;ﾐ BｷﾉWズWﾐﾉWヴｷ RWｴく ヲヰヱヶが S;┞a; 146)

İﾉﾆ ﾆW┣ ﾆ;ﾐ H;ｬﾀズﾉ;┞;ﾐﾉ;ヴS; ABOっRｴ tayini

Gヴｷaﾗﾉゲ DG GWﾉ ABOっRｴ ヲD RT

Mｷﾆヴﾗデ┑ヮ A (ﾏﾗﾐﾗﾆﾉﾗﾐ;ﾉ ;ﾐデｷ-Aが IｪMっIｪGが IﾉﾗﾐWゲヱヶヲヴン Gヲ Щ ヱヶヲヴΑ EヶぶMｷﾆヴﾗデ┑ヮ B (ﾏﾗﾐﾗﾆﾉﾗﾐ;ﾉ ;ﾐデｷ-Bが IｪMが IﾉﾗﾐW Γヶヲヱ AΒぶMｷﾆヴﾗデ┑ヮ AB (ﾏﾗﾐﾗﾆﾉﾗﾐ;ﾉ ;ﾐデｷ-ABが IｪMっIｪGが IﾉﾗﾐWゲヱヶヲヴヵ Fヱヱ DΒがヱヶヲヴΑ Eヶが ΑΒヲヱ DΓぶDVI- ふﾏﾗﾐﾗIﾉﾗﾐ;ﾉ ;ﾐデｷ-D IｪMが IﾉﾗﾐW MS-201) DVIЩ ふﾏﾗﾐﾗIﾉﾗﾐ;ﾉ ;ﾐデｷ-D ﾏｷ┝デ┌ヴW ﾗa IｪMが IﾉﾗﾐWゲ Pン┝ヶヱ ;ﾐS ESDヱMぶ

Gヴｷaﾗﾉゲ DG GWﾉ Cﾗﾐaｷヴﾏ P

MｷIヴﾗデ┌HW A: ふﾏﾗﾐﾗIﾉﾗﾐ;ﾉ ;ﾐデｷ-Aが IｪMが IﾉﾗﾐW Bｷヴﾏ;-1)

MｷIヴﾗデ┌HW Bぎ ふﾏﾗﾐﾗIﾉﾗﾐ;ﾉ ;ﾐデｷ-Bが IｪM ;ﾐデｷHﾗSｷWゲが IﾉﾗﾐW LB-2)

DVI - : ふﾏﾗﾐﾗIﾉﾗﾐ;ﾉ ;ﾐデｷ-D IｪMが IﾉﾗﾐW MS-201)

Gヴｷaﾗﾉゲ DG GWﾉ Aﾐデｷ-D

DVIЩ ふﾏﾗﾐﾗIﾉﾗﾐ;ﾉ ;ﾐデｷ-DIｪMっIｪGが IﾉﾗﾐWゲ Pン┝ヲΓヰが Pン┝ンヵが Pン┝ヶヱが Pン┝ヲヱヲヲン)

Fﾗヴ┘;ヴSっReverse Fﾗヴ┘;ヴS

Fﾗヴ┘;ヴSっReverse

UYUMい

AっB ┗;ヴ┞;ﾐデ ┗W┞; Z;┞ﾀa Dが IATが DAT N;ﾉﾀズﾏ;ゲﾀﾐ; ┞ﾜﾐﾉWﾐSｷヴｷﾉWﾐﾉWヴ ｴ;ヴｷN

ABOっRｴ ゲﾗﾐ┌I┌ﾆWゲｷﾐ ゲﾗﾐ┌N ﾗﾉ;ヴ;ﾆ

ﾗﾐ;┞ﾉ;ﾐﾀヴ

TWゲデ デWﾆヴ;ヴﾉ;ﾐﾀヴくKﾉﾗﾐ a;ヴﾆﾀい

AっB ┗;ヴ┞;ﾐデい Z;┞ﾀaっParsiyel Dい

Wﾆ N;ﾉﾀズﾏ;ﾉ;ヴ ┞;ヮﾀﾉﾀヴ

İﾉﾆ ﾆW┣ ﾆ;ﾐ H;ｬﾀズﾉ;┞;ﾐﾉ;ヴS; ABOっRｴ tayini

VAR YOK

Fﾗヴ┘;ヴS

F っ FわR┌┞┌ﾏゲ┌┣ H;ｬﾀズﾉ;ヴ ｷﾏｴ; WSｷﾉｷヴ

TWﾆヴ;ヴﾉ;┞;ﾐ ﾆ;ﾐ H;ｬﾀズNﾀﾉ;ヴﾀﾐS; ABOっRｴ tayini

AっB ┗;ヴ┞;ﾐデ veya Z;┞ﾀaっParsiyel D

N;ﾉﾀズﾏ;ゲﾀﾐ; ┞ﾜﾐﾉWﾐSｷヴｷﾉWﾐﾉWヴ ｴ;ヴｷN

ABOっRｴ ゲﾗﾐ┌I┌ ﾆWゲｷﾐ ゲﾗﾐ┌N ﾗﾉ;ヴ;ﾆ

ﾗﾐ;┞ﾉ;ﾐﾀヴ

VAR

B;ｬﾀズNﾀ ﾆ;┞ﾀデﾉ;ヴﾀいTüpっ デﾗヴH; ﾆ;ヴﾀズﾀﾆﾉﾀｬﾀﾐ;

┞ﾜﾐWﾉｷﾆ ;ヴ;ズデﾀヴﾏ;ﾉ;ヴ ┞;ヮﾀﾉﾀヴ

YOK

ÖﾐIWﾆｷ H;ｬﾀズﾉ;ヴﾀﾐS;ﾆｷ

ABOっRｴ ゲﾗﾐ┌Nﾉ;ヴﾀ

UYUMい

Gヴｷaﾗﾉゲ DG GWﾉ Cﾗﾐaｷヴﾏ PDVI -

Fﾗヴ┘;ヴS

Gヴｷaﾗﾉゲ DG GWﾉ Anti-DDVIЩ

Ulusal Kan ve Kan Bileşenleri Rehberi (2016) Kan Gruplama Testleri (sayfa- 266)

A/B Varyantları; A ve B gruplarının varyantları monoklonal anti-A ve anti-B ile daha zayıf reaksiyonlar verirler. Örneğin Ax ve Bx değişik reaktiflerle farklı şiddette reaksiyon verebilece ğigibi hic 柵 reaksiyon da vermeyebilir. Varyantların saptanmasında anti -AB, lektin A1, lektin H, A2 hücresi ve anti-A veya anti-B ile uygulanan adsorbsyon/elusyonçalışmalarının faydası vardır. Zayıf A/B antijenlerinin saptanması zordur ve bu nedenle bu tip….

Varyantların saptanmasında «anti -AB» içeren forward yönteminin önemi

- anti-H ふンЩぶ- anti-A1 ふNWｪ)

A (Neg), B (Neg), AB (+1), B-cell (3+)

AX?, O?

A┝ (┞; S; Am) ゲ┌Hｪヴ┌H┌ SWゲデWﾆﾉWヴ

aﾐデｷ-A ぎ NWｪく ┞; S; ふЩっ-)

aﾐデｷ-AB : Poz.Aヱ LWﾆデｷﾐぎ NWｪくH LWﾆデｷﾐ ぎ Pﾗ┣く

• aﾐデｷ-AB Ю aﾐデｷ-A Щ aﾐデｷ-B• aﾐデｷ-AB (a;ヴﾆﾉﾀ ﾆﾉﾗﾐぶ

A┝ (┗W Am) ｷﾉW ヮﾗ┣ｷデｷa

Gヴｷaﾗﾉゲ DG GWﾉ ABOっRｴ ヲD RT

Mｷﾆヴﾗデ┑ヮ A (ﾏﾗﾐﾗﾆﾉﾗﾐ;ﾉ ;ﾐデｷ-Aが IｪMっIｪGが IﾉﾗﾐWゲ ヱヶヲヴン Gヲ Щ ヱヶヲヴΑ EヶぶMｷﾆヴﾗデ┑ヮ B (ﾏﾗﾐﾗﾆﾉﾗﾐ;ﾉ ;ﾐデｷ-Bが IｪMが IﾉﾗﾐW Γヶヲヱ AΒぶMｷﾆヴﾗデ┑ヮ AB (ﾏﾗﾐﾗﾆﾉﾗﾐ;ﾉ ;ﾐデｷ-ABが IｪMっIｪGが IﾉﾗﾐWゲ ヱヶヲヴヵ Fヱヱ DΒがヱヶヲヴΑ Eヶが ΑΒヲヱ DΓぶ

Fig. 1. Results from A forward and B reverse ABO typing of the patient using the gel technique. A and B antigens were clearly absent in antigen typing. Reverse typing failed to detect Anti-A1 or Anti-A2 isoagglutinins in the patient’s serum. Anti-B isoagglutinins were normal (4+). C Antigen typing using further monoclonal reagents including an Anti-AB monoclonal antibody led to very weak agglutination reaction detectable by…..

Aﾐデｷ-A NWｪくFﾗヴ┘;ヴS Gヴ┌ヮﾉ;ﾏ; RW┗WヴゲW Gヴ┌ヮﾉ;ﾏ; Aﾐデｷ-AB デWゲデｷ

Aﾐデｷ-AB ┘W;ﾆ Poz.

B ヴW┗WヴゲW Щ4 Poz.

Aﾐデｷ-A NWｪく

- anti-H ふNeg)- anti-A1 ふNWｪ)

A2B with Anti -A1 ?

A ふNWｪぶが B ふNWｪぶが AB ふNWｪ) A1 IWﾉﾉ ふヱЩぶが B IWﾉﾉ ふNWｪ)

Serumlarında anti-A1 bulundurma oranı; A2 : % 1-8 ; A2B: %25

- AABB Manuel , 17th ed, p 367- Dashkova NG, Ragimov AA, Asoskova TK.Significance of the isoantigen A2 and immune anti -A1 antibodies in transfusion, AnesteziolReanimatol . 2009;(6):62-5

FわRが ;ﾐデｷ-Hが ;ﾐデｷ-A1 Lektin N;ﾉﾀズﾏ;ﾉ;ヴﾀ┞ﾉ; ┗;ヴ┞;ﾐデﾉ;ヴ ;ヴ;ズデﾀヴﾀﾉﾀヴ

TWﾏﾏ┌┣が Aｬ┌ゲデﾗゲが E┞ﾉ┑ﾉ ヲヰヱΓ ;┞ﾉ;ヴﾀﾐS; Türk Kﾀ┣ﾀﾉ;┞ Oヴデ; Aﾐ;Sﾗﾉ┌ BﾜﾉｪW K;ﾐ MWヴﾆW┣ｷ İﾏﾏ┑ﾐﾗｴWﾏ;デﾗﾉﾗﾃｷ L;Hﾗヴ;デ┌┗;ヴﾀﾐS; ┞;ヮﾀﾉ;ﾐ デﾗヮﾉ;ﾏ 176.912 H;ｬﾀズNﾀ┞; ;ｷデ ｪヴ┌ヮﾉ;ﾏ; デWゲデﾉWヴｷ ゲﾗﾐ┌I┌ﾐS; AっB varyant ｪﾜヴ┑ﾉﾏW ﾗヴ;ﾐﾀ ┞;ﾆﾉ;ズﾀﾆ ヰがヰΓХ ふヱヵヵっヱΑヶくΓヱヲぶ ﾗﾉ;ヴ;ﾆ H┌ﾉ┌ﾐﾏ┌ズデ┌ヴく

NOT: A1 Lektin ve H Lektin ゲﾗヴ┌ﾐゲ┌┣ ヴ┌デｷﾐ ｪヴ┌ヮ ;デ;ﾏ;ﾉ;ヴﾀﾐS; ;ヴ;ズデﾀヴﾀﾉﾏ;Sﾀｬﾀ için A2 ve A2B (with-Anti-A1 olanlar hariç) bu

SWｬWヴﾉWﾐSｷヴﾏWﾐｷﾐ SﾀズﾀﾐS; デ┌デ┌ﾉﾏ┌ズデ┌ヴく

TÜRK KIZILAY İMMÜNOHEMATOLOJİ LABORATUVARINDA ANTİKOR TARAMA

• B┌ ;ﾐデｷﾆﾗヴﾉ;ヴﾀﾐ Hｷヴ ﾆﾀゲﾏﾀ Sﾗｬ;ﾉ ┞ﾗﾉﾉ;ヴS;ﾐ ﾗﾉ┌ズ┌ヴが Hｷヴ ﾆﾀゲﾏﾀ ｷゲW デヴ;ﾐゲa┑┣┞ﾗﾐ ┞; S; ｪWHWﾉｷﾆ ﾐWSWﾐｷ ｷﾉW ┞;H;ﾐIﾀ ;ﾐデｷﾃWﾐﾉWヴW ﾏ;ヴ┌┣ ﾆ;ﾉﾏ; ゲﾗﾐ┌I┌ ｪWﾉｷズｷヴく

• B┌ ﾐWSWﾐﾉW HｷヴSWﾐ a;┣ﾉ; デヴ;ﾐゲa┑┣┞ﾗﾐ ┞;ヮﾀﾉﾏﾀズ ┞; S; ┌┣┌ﾐ ゲ┑ヴWﾉｷ デヴ;ﾐゲa┑┣┞ﾗﾐ デWS;┗ｷゲｷ ｪﾜヴﾏ┑ズ ﾆｷズｷﾉWヴ ｷﾉW ﾏ┌ﾉデｷヮ;ヴ ﾆ;Sﾀﾐﾉ;ヴS; ヮﾗ┣ｷデｷa ゲ;ヮデ;ﾐﾏ; ﾗﾉ;ゲﾀﾉﾀｬﾀ ┞┑ﾆゲWﾆデｷヴく

B;ｬﾀズNﾀ ゲWヴ┌ﾏ ┞; S; ヮﾉ;┣ﾏ;ゲﾀﾐS; Sﾗｬ;ﾉ ;ﾐデｷﾆﾗヴﾉ;ヴ ﾗﾉ;ﾐ anti-A ve anti-B SﾀズﾀﾐS;ﾆｷ Wヴｷデヴﾗゲｷデ ;ﾐデｷﾆﾗヴﾉ;ヴﾀﾐﾀﾐ ふirregularっ S┑┣Wﾐゲｷ┣っHWﾆﾉWﾐﾏWSｷﾆ ;ﾐデｷﾆﾗヴﾉ;ヴぶ ﾗﾉ┌ヮ ﾗﾉﾏ;Sﾀｬﾀﾐﾀﾐ ｪﾜゲデWヴｷﾉﾏWゲｷSｷヴく

ANTİKOR TARAMA

• Kﾉｷﾐｷﾆ ﾜﾐWﾏｷ ﾗﾉ;ﾐ ;ﾐデｷﾆﾗヴ デ;ヴ;ﾏ; ｪWヴWﾆゲｷﾐｷﾏｷき

• H;ゲデ;S; ｴWﾏﾗﾉｷデｷﾆ ヴW;ﾆゲｷ┞ﾗﾐ┌ WﾐｪWﾉﾉWﾏWﾆ

• YWﾐｷSﾗｬ;ﾐ ｴWﾏﾗﾉｷデｷﾆ ｴ;ゲデ;ﾉﾀｬﾀﾐﾀ WﾐｪWﾉﾉWﾏWﾆ

• Pﾉ;┣ﾏ; aヴ;ﾆゲｷ┞ﾗﾐ┌ﾐS; ゲデ;ﾐS;ヴデﾉ;ヴ; ┌┞ｪ┌ﾐﾉ┌ｬ┌ ゲ;ｬﾉ;ﾏ;ﾆ

• B;ｬﾀズNﾀﾉ;ヴS;ﾆｷ ;ﾐデｷﾆﾗヴﾉ;ヴ ﾐWSWﾐｷ┞ﾉW N;ヮヴ;┣ ﾆ;ヴズﾀﾉ;ズデﾀヴﾏ; デWゲデﾉWヴｷﾐSW ﾏｷﾐﾜヴ ┌┞ｪ┌ﾐゲ┌┣ﾉ┌ﾆﾉ;ヴﾀﾐ ﾜﾐ┑ﾐW ｪWNﾏWﾆく

ANTİKOR TARAMA

• Aﾐデｷﾆﾗヴ デ;ヴ;ﾏ; デWゲデｷき• İﾉﾆ ﾆW┣ ﾆ;ﾐっﾆ;ﾐ HｷﾉWズWﾐｷ H;ｬﾀズﾉ;┞;ﾐ

デ┑ﾏ H;ｬﾀズNﾀﾉ;ヴ;• Sﾗﾐ H;ｬﾀズﾀﾐS;ﾐ H┌ ┞;ﾐ; ｪWHWﾉｷﾆ

┗W┞; デヴ;ﾐゲa┑┣┞ﾗﾐ ﾜ┞ﾆ┑ゲ┑ ﾗﾉ;ﾐ H;ｬﾀズNﾀﾉ;ヴ;

• DWｬWヴﾉWﾐSｷヴﾏWき • K┌ﾉﾉ;ﾐﾀﾉ;I;ﾆ ﾆ;ﾐﾉ;ヴS; ;ﾐデｷﾆﾗヴ

デ;ヴ;ﾏ;ゲﾀﾐﾀﾐ ゲﾗﾐ┌I┌ ﾐWｪ;デｷa ﾗﾉﾏ;ﾉﾀSﾀヴく

• T;ヴ;ﾏ; デWゲデｷ ヮﾗ┣ｷデｷa ﾗﾉ;ﾐ ﾆ;ﾐ HｷﾉWズWﾐﾉWヴｷ ｷﾏｴ; WSｷﾉｷヴく

ANTİKOR TARAMAUSA

Gヴｷaﾗﾉゲ SWヴﾗ-CyteÆ Pﾗﾗﾉ ヰくΒХ

K┌ﾉﾉ;ﾐﾀﾉﾏ;ﾆデ; ﾗﾉ;ﾐ ヴW;ﾃWﾐｷNWヴｷｬｷき

• Rｴ ふDが Cが Iが Eが WがC┘)• Kell ふKが k)• D┌aa┞ ふF┞aが F┞b)• KｷSS ふJﾆaが Jﾆb)• LW┘ｷゲ ふLeaが LWb)• P ふP1)• MN ふMが Nが Sが ゲ)• L┌デｴWヴ;ﾐ ふLub)

Tﾗヮﾉ┌ﾏS; Wﾐ ゲﾀﾆ ﾆ;ヴズﾀﾉ;ズﾀﾉ;ﾐ ﾆﾉｷﾐｷﾆ ;NﾀS;ﾐ ;ﾐﾉ;ﾏﾉﾀ ;ﾐデｷﾆﾗヴﾉ;ヴぎ

• Anti-E• Anti-K• Anti-I• Anti- Jﾆa

• Anti-F┞a

ANTİKOR TARAMA

Gヴｷaﾗﾉゲ SWヴﾗ-CyteÆ Pﾗﾗﾉ ヰくΒХ

TWﾏﾏ┌┣が Aｬ┌ゲデﾗゲが E┞ﾉ┑ﾉ ヲヰヱΓ ;┞ﾉ;ヴﾀﾐS; Türk Kﾀ┣ﾀﾉ;┞ Oヴデ; Aﾐ;Sﾗﾉ┌ BﾜﾉｪW K;ﾐ MWヴﾆW┣ｷ İﾏﾏ┑ﾐﾗｴWﾏ;デﾗﾉﾗﾃｷ L;Hﾗヴ;デ┌┗;ヴﾀﾐS; 176.912H;ｬﾀズNﾀ┞; ;ｷデ ｪヴ┌ヮﾉ;ﾏ; デWゲデﾉWヴｷ ┞;ヮﾀﾉﾏﾀズデﾀヴく

B┌ﾐﾉ;ヴﾀﾐ ;ヴ;ゲﾀﾐS;ﾐ ｷﾉﾆ ﾆW┣ ﾆ;ﾐっﾆ;ﾐ HｷﾉWズWﾐｷ H;ｬﾀズﾉ;┞;ﾐ ┗W ゲﾗﾐ H;ｬﾀズﾀﾐS;ﾐ H┌ ┞;ﾐ; ｪWHWﾉｷﾆ ┗W┞; デヴ;ﾐゲa┑┣┞ﾗﾐ ﾜ┞ﾆ┑ゲ┑ ﾗﾉ;ﾐ H;ｬﾀズNﾀﾉ;ヴ; ┗W ﾜﾐIWﾆｷ H;ｬﾀズﾀﾐS; ;ﾐデｷﾆﾗヴ デ;ヴ;ﾏ; ゲﾗﾐ┌I┌ ヮﾗ┣ｷデｷa ﾗﾉ;ﾐﾉ;ヴ; ;ﾐデｷﾆﾗヴ デ;ヴ;ﾏ;ゲﾀ ┞;ヮﾀﾉﾏ;ゲﾀ ゲﾗﾐ┌I┌ﾐS; ヮﾗ┣ｷデｷa ゲ;ヮデ;ﾐ;ﾐ デﾗヮﾉ;ﾏ 466 ふヰくヲヶ%) H;ｬﾀズNﾀ┞; ait ürün ｷﾏｴ; WSｷﾉﾏｷズデｷヴく

RｴD K;ﾐ Gヴ┌H┌ BWﾉｷヴﾉWﾏW

• D ┞┑ﾆゲWﾆ ﾗヴ;ﾐS; ｷﾏﾏ┑ﾐﾗﾃWﾐｷﾆ ﾗﾉS┌ｬ┌ﾐS;ﾐ ヴ┌デｷﾐ ﾗﾉ;ヴ;ﾆ Rｴ D デWゲデｷ ┞;ヮﾀﾉﾀヴく

• 4Щ ズｷSSWデｷﾐSW aglütine ﾗﾉ;ﾐ WヴｷデヴﾗゲｷデﾉWヴ Rｴ D Pﾗ┣ｷデｷa ﾗﾉ;ヴ;ﾆ ﾆ;H┌ﾉ WSｷﾉｷヴく

• < ヴЩ aglütine ﾗﾉ;ﾐﾉ;ヴS; ┞; S; ｴｷN aglütine ﾗﾉﾏ;┞;ﾐﾉ;ヴS; VARYANT D ふ┣;┞ﾀa Dが parsiyel Dぶ ;ヴ;ズデﾀヴﾏ;ゲﾀ ┞;ヮﾀﾉﾀヴく

RｴD K;ﾐ Gヴ┌H┌ BWﾉｷヴﾉWﾏW

Z;┞ﾀa D• D ;ﾐデｷﾃWﾐｷ ┗;ヴき

• ;ﾐI;ﾆ ;┣ ゲ;┞ﾀS;• ┞;ヮﾀゲ;ﾉ ﾗﾉ;ヴ;ﾆ NORMALふD ｪWﾐｷ デ;ヴ;aﾀﾐS;ﾐ ┣;┞ﾀaﾉ;デﾀﾉﾏﾀズ WﾆゲヮヴWゲ┞ﾗﾐ ﾗﾉS┌ｬ┌ ｷNｷﾐ デ;ﾏ Hｷヴ D ;ﾐデｷﾃWﾐｷ ﾏW┗I┌デデ┌ヴ a;ﾆ;デ ｴWヴ ｴ┑IヴWSW S;ｴ; ;┣ D ;ﾐデｷﾃWﾐｷ ┗;ヴSﾀヴぶ

• Z;┞ﾀa D ゲ;ヮデ;ﾐ;ﾐ H;ｬﾀズNﾀﾉ;ヴ Rｴ D ヮﾗ┣ｷデｷa ﾗﾉ;ヴ;ﾆ ;デ;ﾐﾀヴが N┑ﾐﾆ┑ Rｴ ﾐWｪ;デｷa ;ﾉﾀIﾀS; ヴW;ﾆゲｷ┞ﾗﾐ ﾗﾉ┌ズデ┌ヴ┌ヴく

RｴD K;ﾐ Gヴ┌H┌ BWﾉｷヴﾉWﾏW

Parsiyel D ふKﾀゲﾏｷ Dぶ

• D ;ﾐデｷﾃWﾐｷﾐｷﾐ Hｷヴ ┗W┞; S;ｴ; a;┣ﾉ; Wヮｷデﾗヮ┌┞ﾗﾆデ┌ヴが ┞;ﾐｷ D ;ﾐデｷﾃWﾐｷ NORMAL DEĞİLDİRく

• Eヮｷデﾗヮﾉ;ヴﾀ Wﾆゲｷﾆ ﾗﾉ;ﾐ ｪヴ┌ヮЭ Wﾐ ゲﾀﾆ K;デWｪﾗヴｷ DVIげSﾀヴ. Rｴ ﾐWｪ;デｷa ;ﾉﾀIﾀ Wﾆゲｷﾆ Wヮｷデﾗヮﾉ;ﾆ;ヴズﾀﾉ;ズﾏ;┞ﾀ デ;ﾆｷHWﾐ anti-D ﾗﾉ┌ズデ┌ヴ┌ヴく

B┌ ﾐWSWﾐﾉWき• BAĞIŞÇILARDA DVIЩ ふDVIげ┞ﾀ saptayabilen)

• ｴ;ゲデ;ﾉ;ヴS; DVI- ヴW;ﾃWﾐﾉWヴ ﾆ┌ﾉﾉ;ﾐﾀﾉﾀヴく

• Parsiyel D ヮﾗ┣ｷデｷa H;ｬﾀズNﾀﾉ;ヴ たRｴ D ヮﾗ┣ｷデｷaだ ﾗﾉ;ヴ;ﾆ WデｷﾆWデﾉWﾐｷヴく

RｴD K;ﾐ Gヴ┌H┌ BWﾉｷヴﾉWﾏW

Z;┞ﾀ

a D Ç

;ﾉﾀズﾏ

;ゲﾀ

Gヴｷaﾗﾉゲ Anti-D IｪG Mﾗﾐﾗ-TypeRHヱ

DVIЩ ふﾏﾗﾐﾗIﾉﾗﾐ;ﾉ ;ﾐデｷ-D IｪM;ﾐデｷHﾗSｷWゲ ﾗa ｴ┌ﾏ;ﾐ ﾗヴｷｪｷﾐが

IﾉﾗﾐW ESDヱ)

Gヴｷaﾗﾉゲ DG GWﾉ ABOっRｴ ヲD RTDVI- ふﾏﾗﾐﾗIﾉﾗﾐ;ﾉ ;ﾐデｷ-D IｪM ;ﾐデｷHﾗSｷWゲ ﾗa ｴ┌ﾏ;ﾐ

ﾗヴｷｪｷﾐが IﾉﾗﾐW MS-ヲヰヱ) わ

DVIЩ ふﾏﾗﾐﾗIﾉﾗﾐ;ﾉ anti-D ﾏｷ┝デ┌ヴW ﾗa IｪM ;ﾐデｷHﾗSｷWゲ ﾗa ｴ┌ﾏ;ﾐ ﾗヴｷｪｷﾐ ;ﾐS IﾉﾗﾐWゲ Pン┝ヶヱ ;ﾐS ESDヱMぶ

Fﾗヴ┘

;ヴSっ

Re

vers

e

Gヴｷaﾗﾉゲ DG GWﾉ Cﾗﾐaｷヴﾏ PDVI- ふﾏﾗﾐﾗIﾉﾗﾐ;ﾉ ;ﾐデｷ-D IｪM ;ﾐデｷHﾗSｷWゲ ﾗa ｴ┌ﾏ;ﾐ

ﾗヴｷｪｷﾐが IﾉﾗﾐW MS-ヲヰヱ)

Gヴｷaﾗﾉゲ DG GWﾉ Aﾐデｷ-D

DVIЩ ふﾏﾗﾐﾗIﾉﾗﾐ;ﾉ ;ﾐデｷ-D IｪMっIｪGが IﾉﾗﾐWゲ Pン┝ヲΓヰが Pン┝ンヵが Pン┝ヶヱが Pン┝ヲヱヲヲン)

Fﾗヴ┘

;ヴS

Rh

D <

4Щ

┗W┞;

ﾐWｪ

;デｷa

Rh

D аヴ

Щ ┗W

┞; ﾐ

Wｪ;デ

ｷa

ЩDAT N;ﾉﾀズﾀﾉﾀヴ

ヲヰヱΒ ┞ﾀﾉﾀﾐS; Aﾐデｷ-D ﾆｷデ ┞;ヮﾀゲﾀ ┗W ﾆﾉﾗﾐ SWｬｷズｷﾆﾉｷｬｷ ┞;ヮﾀﾉﾏ;ゲﾀ ゲﾗﾐヴ;ゲﾀﾐS;き

D;ｴ; ﾜﾐIW «Anti-D blend monoclonal, human

IgG+IgM in DG Gel Coombs, clone TH-28/ MS-26»

ｷﾉW ┞;ヮﾀﾉ;ﾐ N;ﾉﾀズﾏ;S; Z;┞ﾀa D ﾐWｪ;デｷa ﾗﾉ;ヴ;ﾆ ゲ;ヮデ;ﾐ;ﾐ ヶふAﾉデﾀぶ ﾐ┌ﾏ┌ﾐWﾐｷﾐ «Anti-D IgG Mono-

Type RH1, monoclonal anti-D IgM antibodies of

human origin, clone ESD1» ｷﾉW DAT ﾐWｪ;デｷa ﾗﾉS┌ｬ┌ ｴ;ﾉSW Z;┞ﾀa D デWゲデｷﾐSW ふヱЩぶ ヮﾗ┣ｷデｷa ヴW;ﾆゲｷ┞ﾗﾐ ┗WヴSｷｬｷ ｪﾜヴ┑ﾉﾏ┑ズデ┑ヴく

Grifols Iﾏﾏ┌ﾐﾗｴWﾏ;デﾗﾉﾗｪ┞ Center /Texas ｷﾉW ┞;ヮﾀﾉ;ﾐ ﾗヴデ;ﾆ N;ﾉﾀズﾏ;S; ｪWﾐﾗデｷヮﾉWﾐSｷヴﾏWゲﾗﾐヴ;ゲﾀﾐS; H┌ ヶふAﾉデﾀぶ ﾐ┌ﾏ┌ﾐWﾐｷﾐ たRHDゅ┘W;ﾆ D type 11 ｪWﾐﾗデ┞ヮW» ﾗﾉS┌ﾆﾉ;ヴﾀ ;ﾐﾉ;ズﾀﾉﾏﾀズデﾀヴく

RｴD K;ﾐ Gヴ┌H┌ BWﾉｷヴﾉWﾏW

BヴW┣ｷﾉ┞;げS; ヲヰヱヵ ┞ﾀﾉﾀﾐS; ┞;ヮﾀﾉ;ﾐ Hｷヴ N;ﾉﾀズﾏ;S;き

T┑ヮ デWﾆﾐｷｬｷ ｷﾉW RｴD ﾐWｪ;デｷa ﾗﾉ;ヴ;ﾆ HWﾉｷヴﾉWﾐWﾐ 152 ﾐ┌ﾏ┌ﾐWが ┑N ;┞ヴﾀ デWﾆﾐｷﾆ ﾆ┌ﾉﾉ;ﾐﾀﾉ;ヴ;ﾆ ┞WﾐｷSWﾐ SWｬWヴﾉWﾐSｷヴｷﾉﾏｷズく

D;ｴ; ﾜﾐIW RｴD ﾐWｪ;デｷa ﾗﾉ;ヴ;ﾆ SWｬWヴﾉWﾐSｷヴｷﾉWﾐ Αヰﾐ┌ﾏ┌ﾐW ふ1.43%ぶが N;ﾉﾀズﾏ;S; Wﾐ ｷ┞ｷ ヮWヴaﾗヴﾏ;ﾐゲﾀ ｪﾜゲデWヴWﾐ ESDヱ ﾆﾉﾗﾐ┌ﾐ; ゲ;ｴｷヮ JWﾉ デWﾆﾐｷｬｷ ｷﾉW RｴD ヮﾗ┣ｷデｷaﾗﾉ;ヴ;ﾆ HWﾉｷヴﾉWﾐﾏｷズく

RｴD K;ﾐ Gヴ┌H┌ BWﾉｷヴﾉWﾏW

2019 ┞ﾀﾉﾀﾐS; Grifols Iﾏﾏ┌ﾐﾗｴWﾏ;デﾗﾉﾗｪ┞ Center /Texas ｷﾉW ┞;ヮデﾀｬﾀﾏﾀ┣ ﾗヴデ;ﾆ N;ﾉﾀズﾏ;S;が T┑ヴﾆ Kﾀ┣ﾀﾉ;┞ Aﾐﾆ;ヴ; İﾏﾏ┑ﾐﾗｴWﾏ;デﾗﾉﾗﾃｷ L;Hﾗヴ;デ┌┗;ヴﾀﾐS; Z;┞ﾀa D N;ﾉﾀズﾏ;ゲﾀﾐS; ﾐWデ ﾆ;ヴ;ヴ ┗WヴｷﾉWﾏW┞Wﾐ Hｷヴ ﾐ┌ﾏ┌ﾐWﾐｷﾐ ｪWﾐﾗデｷヮﾉWﾐSｷヴﾏW N;ﾉﾀズﾏ;ゲﾀ ゲﾀヴ;ゲﾀﾐS; たD-likeだ AﾐデｷﾃWﾐ ﾆﾗSﾉ;┞;ﾐ S;ｴ; ﾜﾐIW デ;ﾐﾀﾏﾉ;ﾐﾏ;ﾏﾀズ Hｷヴ ┗;ヴ┞;ﾐデ RHCE alleli H┌ﾉ┌ﾐﾏ┌ズ ﾗﾉﾏ;ゲﾀ Hｷ┣ﾉWヴSW ┗W Grifols ﾉ;Hﾗヴ;デ┌┗;ヴﾉ;ヴﾀﾐS; H┑┞┑ﾆ ｴW┞WI;ﾐ ┌┞;ﾐSﾀヴSﾀく

B┌ N;ﾉﾀズﾏ;が ABD ve İデ;ﾉ┞;げS;ﾐ ﾆ;デﾀﾉ;ﾐ HｷヴWヴ ﾏWヴﾆW┣ ┗W T┑ヴﾆ Kﾀ┣ﾀﾉ;┞ İﾏﾏ┑ﾐﾗｴWﾏ;デﾗﾉﾗﾃｷ L;Hﾗヴ;デ┌┗;ヴﾉ;ヴﾀﾐﾀﾐ ﾆ;デﾀﾉﾀﾏﾀ┞ﾉ; Nﾗﾆ ﾏWヴﾆW┣ﾉｷ ﾗﾉ;ヴ;ﾆ SW┗;ﾏ WデﾏWﾆデWSｷヴく

Ç;ﾉﾀズﾏ;S;ﾐ Nﾀﾆ;I;ﾆ ゲﾗﾐ┌Nが HWﾉﾆｷ SW ┑ﾉﾆWﾏｷ┣SWﾆｷ Sﾗﾐﾜヴ Wヴｷデヴﾗゲｷデ ;ﾐデｷﾃWﾐ ヮヴﾗaｷﾉｷ ;NﾀゲﾀﾐS;ﾐ ┞Wﾐｷ Hｷヴ ┞;ﾆﾉ;ズﾀﾏﾀ HWヴ;HWヴｷﾐSW ｪWデｷヴWIWﾆデｷヴく VW HWﾉﾆｷが Grifols ｪｷHｷ ﾆｷデ ゲ;ｬﾉ;┞;ﾐ aｷヴﾏ;ﾉ;ヴﾀﾐが ┑ﾉﾆWﾏｷ┣SW デｷI;ヴｷ ﾗﾉ;ヴ;ﾆ S;ｬﾀデﾀﾏﾀﾐﾀ ┞;ヮデﾀﾆﾉ;ヴﾀ ﾆｷデﾉWヴｷﾐ ﾆﾉﾗﾐﾉ;ヴﾀﾐS; SWｬｷズｷﾆﾉｷﾆっｪ┑ﾐIWﾉﾉWﾏW ┞;ヮﾏ;ﾉ;ヴﾀﾐ; ﾜﾐI┑ ﾗﾉ;I;ﾆデﾀヴく

YWﾐｷ Hｷヴ ;ﾐデｷﾃWﾐ ﾏｷい

Rｴ subgrupっKell わ T┑ヴﾆ Kﾀ┣ﾀﾉ;┞ Dﾗﾐﾜヴ H;┗┌┣┌

Rｴ subgrupっKell HWﾉｷヴﾉWﾏW

• anti-Dが ;ﾐデｷ-Cが ;ﾐデｷ-Iが ;ﾐデｷ-Eが ;ﾐデｷ-W ｷNWヴWﾐ ヴW;ﾃWﾐﾉWヴﾉW H;ｬﾀズNﾀっｴ;ゲデ; Wヴｷデヴﾗゲｷデ ;ﾐデｷﾃWﾐﾉWヴｷ ﾆ;ヴズﾀﾉ;ズデﾀヴﾀﾉﾀヴく

• Rｴ ;ﾐデｷﾃWﾐﾉWヴｷ ｪ┑Nﾉ┑ ｷﾏﾏ┌ﾐﾗﾃWﾐﾗﾉS┌ｬ┌ﾐS;ﾐ Rｴ aWﾐﾗデｷヮ デ;┞ｷﾐｷ HｷヴSWﾐ a;┣ﾉ; デヴ;ﾐゲa┑┣┞ﾗﾐ ┞; S; ┌┣┌ﾐ ゲ┑ヴWﾉｷ デヴ;ﾐゲa┑┣┞ﾗﾐ デWヴ;ヮｷゲｷ ｪﾜヴWIWﾆ ｴ;ゲデ;ﾉ;ヴ ｷNｷﾐ ﾜﾐWﾏﾉｷSｷヴく

Rｴ subgrupっKell HWﾉｷヴﾉWﾏW

• H;ゲデ;ﾐﾀﾐ Rｴ aWﾐﾗデｷヮｷﾐW ┌┞ｪ┌ﾐ ﾗﾉﾏ;┞;ﾐ デヴ;ﾐゲa┑┣┞ﾗﾐﾉ;ヴS; ｴ;ゲデ;S; H┌ﾉ┌ﾐﾏ;┞;ﾐ ;ﾐI;ﾆ ﾆ;ﾐ HｷﾉWズWﾐｷﾐSW H┌ﾉ┌ﾐ;ﾐ ;ﾐデｷﾃWﾐﾉWヴW ﾆ;ヴズﾀ ;ﾐデｷﾆﾗヴ ｪWﾉｷズWIWｬｷﾐSWﾐ ゲﾗﾐヴ;ﾆｷ デヴ;ﾐゲa┑┣┞ﾗﾐﾉ;ヴS; ｴWﾏﾗﾉｷデｷﾆ ヴW;ﾆゲｷ┞ﾗﾐﾉ;ヴ ﾗﾉ┌ズ;Hｷﾉｷヴく B┌ ﾐWSWﾐﾉW H┌ ｴ;ゲデ;ﾉ;ヴ; ﾆWﾐSｷ aWﾐﾗデｷヮｷﾐW ┌┞ｪ┌ﾐ ふﾆWﾐSｷゲｷﾐSW H┌ﾉ┌ﾐﾏ;┞;ﾐ ;ﾐデｷﾃWﾐﾉWヴｷ ｷNWヴﾏW┞Wﾐぶ ﾆ;ﾐ HｷﾉWズWﾐﾉWヴｷ ﾆ┌ﾉﾉ;ﾐﾀﾉﾀヴく

ヲヰヱΒ ┞ﾀﾉﾀﾐS; T┑ヴﾆ Kﾀ┣ﾀﾉ;┞が Tヴ;ﾐゲa┑┣┞ﾗﾐ MWヴﾆW┣ﾉWヴｷﾐSWﾐ デ;ﾉWヮ WSｷﾉWﾐ Rｴsubgrup HWﾉｷヴデｷﾉﾏｷズ 57.613 HｷﾉWズWﾐｷﾐ 45.839�┌ﾐ┌ ふΑΓがヶ%) subgrup ｷゲデWﾏｷﾐW ┌┞ｪ┌ﾐ ﾗﾉ;ヴ;ﾆ デWS;ヴｷﾆ Wデﾏｷズデｷヴくゅ *T┑ヴﾆ Kﾀ┣ﾀﾉ;┞ BT M┑S┑ヴS┑ヴげﾉ┑ｬ┑ verilerine göre

TEŞEKKÜRLER