• Title/Summary/Keyword: Acute hemolytic transfusion reaction

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Case of Acute Hemolytic Transfusion Reaction due to Anti-Fya Alloantibody in a Patient with Autoimmune Hemolytic Anemia (자가면역용혈환자에서 항-Fya 동종항체에 의한 급성용혈성수혈반응 1예)

  • Choi, Seung Jun;Nah, Hyunjin;Kim, Yundeok;Kim, Sinyoung;Kim, Hyun Ok
    • The Korean Journal of Blood Transfusion
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    • v.29 no.3
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    • pp.320-327
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    • 2018
  • A 72-year-old man with general weakness visited the outpatient clinic of the hematology department. The patient had been treated under the diagnosis of autoimmune hemolytic anemia for 2 years. His hemoglobin level at the time of the visit was 6.3 g/dL, and a blood transfusion was requested to treat his anemia. The patient's blood type was A, RhD positive. Antibody screening and identification test showed agglutination in all reagent cells with a positive reaction to autologous red blood cells (RBCs). He had a prior transfusion history with three least incompatible RBCs. The patient returned home after receiving one unit of leukoreduced filtered RBC, which was the least incompatible blood in the crossmatching test. After approximately five hours, however, fever, chills, dyspnea, abdominal pain, and hematuria appeared and the patient returned to the emergency room next day after the transfusion. The $anti-Fy^a$ antibody, which was masked by the autoantibody, was identified after autoadsorption using polyethylene glycol. He was diagnosed with an acute hemolytic transfusion reaction due to $anti-Fy^a$ that had not been detected before the transfusion. In this setting, it is necessary to consider the identification of coexisting alloantibodies in patients with autoantibodies and to become more familiar with the method of autoantibody adsorption.

Perioperative red blood cell transfusion in orofacial surgery

  • Park, So-Young;Seo, Kwang-Suk;Karm, Myong-Hwan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.3
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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.

Prevalence of dog erythrocyte antigen (DEA) 1 among Jindo dogs (진돗개에서 개적혈구항원(dog erythrocyte antigen) 1 혈액형 조사)

  • Lee, Jeong-Chi
    • Korean Journal of Veterinary Service
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    • v.41 no.4
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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.

Frequency of Red Blood Cell Antigens According to Parent Ethnicity in Korea Using Molecular Typing

  • Shin, Kyung-Hwa;Lee, Hyun-Ji;Kim, Hyung-Hoi;Hong, Yun Ji;Park, Kyoung Un;Kim, Min Ju;Kwon, Jeong-Ran;Choi, Young-Sil;Kim, Jun Nyun
    • Annals of Laboratory Medicine
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    • v.38 no.6
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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.