• 대한수혈학회지
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• 제29권3호
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• pp.320-327
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• 2018

72세 남자 환자가 전신 무력감을 호소하면서 본원 혈액내과 외래로 내원하였다. 환자는 내원 2년 전 온난자가항체에 의한 자가면역용혈빈혈로 진단받고 치료 중이었다. 내원 당시 환자의 혈색소 수치는 6.3 g/dL로, 빈혈을 교정하기 위해 수혈이 의뢰되었다. 환자의 혈액형은 A형, RhD 양성이었고, 비예기항체 검사에서 범응집 소견 및 자가대조검사에서 양성 소견을 보이고 과거 교차시험에서 최소반응강도를 보이는 적혈구 3단위를 수혈받은 기왕력이 있어, ABO 동형의 적혈구와 교차시험을 하여 최소반응강도를 보이는 적혈구 1단위를 출고하였다. 환자는 수혈을 받은 후 별다른 증상 없이 귀가하였으나, 귀가 후 약 5시간 후부터 발생한 발열, 오한, 호흡곤란, 복통, 혈뇨를 주소로 수혈 다음 날 본원 응급실로 내원하였다. Polyethylene glycol을 이용한 자가흡착검사 후 획득한 상층액을 이용하여 시행한 비예기항체검사에서 항-$Fy^a$가 동정되어, 자가 항체에 의해 가려져 수혈 전에 검출하지 못한 항-$Fy^a$에 의한 급성용혈성수혈반응으로 진단하였다. 본 증례를 통해 자가항체가 동정되는 환자에 대해서 반드시 공존하는 동종항체 확인에 대한 고려가 필요하다는 것을 인지하게 되었고, 이런 자가항체를 제거하여 검사하기 위해 자가흡착검사 방법에 대해 좀 더 익숙해질 필요가 있다는 경험을 하였다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권3호
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• pp.163-181
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• 2017

In the field of orofacial surgery, a red blood cell transfusion (RBCT) is occasionally required during double jaw and oral cancer surgery. However, the question remains whether the effect of RBCT during the perioperative period is beneficial or harmful. The answer to this question remains challenging. In the field of orofacial surgery, transfusion is performed for the purpose of oxygen transfer to hypoxic tissues and plasma volume expansion when there is bleeding. However, there are various risks, such as infectious complications (viral and bacterial), transfusion-related acute lung injury, ABO and non-ABO associated hemolytic transfusion reactions, febrile non-hemolytic transfusion reactions, transfusion associated graft-versus-host disease, transfusion associated circulatory overload, and hypersensitivity transfusion reaction including anaphylaxis and transfusion-related immune-modulation. Many studies and guidelines have suggested RBCT is considered when hemoglobin levels recorded are 7 g/dL for general patients and 8-9 g/dL for patients with cardiovascular disease or hemodynamically unstable patients. However, RBCT is occasionally an essential treatment during surgeries and it is often required in emergency cases. We need to comprehensively consider postoperative bleeding, different clinical situations, the level of intra- and postoperative patient monitoring, and various problems that may arise from a transfusion, in the perspective of patient safety. Since orofacial surgery has an especially high risk of bleeding due to the complex structures involved and the extensive vascular distribution, measures to prevent bleeding should be taken and the conditions for a transfusion should be optimized and appropriate in order to promote patient safety.

• 한국동물위생학회지
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• 제41권4호
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• pp.271-276
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• 2018

This study was conducted to investigate the prevalence of dog erythrocyte antigen (DEA) 1 with DEA 1.1 and DEA 1.2 on 122 Jindo dogs (29 males, 93 females) from 2014 to 2015 using a monoclonal antibody card kit (blood typing card kit, Korea Animal Blood Bank Inc., South Korea). Among the tested dogs, 14.8% (18/122) were positive for the DEA 1.1 antigen and 85.2% (104/122) were positive for the DEA 1.2 antigen. The prevalence of positive types for the DEA 1.2 antigen was significantly higher than the DEA 1.1 antigen (P<0.01). The prevalence of positive types for the DEA 1.1 antigen was higher in white-haired Jindo dogs than yellow-haired dogs (P<0.05). However, there was no gender difference in the prevalence of the DEA 1.1 antigen (P=0.665). The incidence of sensitization after the first transfusion without blood group test was 12.6% and the incidence of acute hemolytic transfusion reaction after the second transfusion in the same immunized dogs was 1.6%. Therefore, the blood group test for the DEA 1 antigen should be performed for Jindo dogs to ensure safe and effective transfusion therapy and further studies remain to be conducted for other DEAs among Jindo dogs.

• Annals of Laboratory Medicine
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• 제38권6호
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• pp.599-603
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• 2018

Frequencies of red blood cell (RBC) blood group antigens differ by ethnicity. Since the number of immigrants is increasing in Korea, RBC antigens should be assessed in children/youths with parents of different ethnicities to ensure safe transfusions. We investigated the frequency of RBC antigens, except for ABO and RhD, in 382 children and youths with parents having Korean and non-Korean ethnicities. Subjects were divided into those with ethnically Korean parents (Korean group; N=252) and those with at least one parent of non-Korean ethnicity (non-Korean group; N=130). The 37 RBC antigens were genotyped using the ID CORE XT system (Progenika Biopharma-Grifols, Bizkaia, Spain). The frequencies of the Rh (E, C, e, $hr^S$, and $hr^B$), Duffy ($Fy^a$), MNS ($Mi^a$), and Cartwright ($Yt^b$) antigens differed significantly between the two groups. Eight and 11 subjects in the Korean and non-Korean groups, respectively, exhibited negative expression of high-frequency antigens, whereas 14 subjects in the non-Korean group showed positive expression of low-frequency antigens. The frequency of RBC antigens has altered alongside demographic changes in Korea and might lead to changes in distribution of RBC antibodies that cause acute or delayed hemolytic transfusion reaction.