• The Korean Journal of Blood Transfusion
• /
• v.29 no.3
• /
• pp.282-290
• /
• 2018

Background: Anti-E or paired anti-E/-c antibodies can develop in patients with the Rh CDe phenotype. This study examined the differences in transfusion in patients with the CDe phenotype according to formation of anti-E or anti-E/-c antibodies. Methods: Retrospective reviews were carried out on the results of antibody identification tests performed in 2014. The Rh phenotype and antibody specificity were investigated. The transfusion and medical records of patients with the CDe phenotype were examined. Results: In total, 76 patients were included in the review. Of these 76 patients, 38 (50.0%) were of the CDe phenotype. Anti-E antibodies were the most frequent (60.5%), followed by anti-E/-c antibodies (23.7%). The total transfusion units and platelet transfusion units were significantly higher in patients with anti-E/-c antibodies (P=0.028 and P=0.01, respectively). The distribution of categorized diseases was similar in the patients with the anti-E and anti-E/-c antibodies. A frequency of transfusion episodes greater than or equal to four was higher in patients with hepatobiliary diseases (85.7%). Conclusion: In CDe phenotype patients, platelet transfusion was significantly higher in the anti-E/-c positive group than the anti-E positive group, indicating that platelets play a role in red blood cell alloimmunization. Because E is the most immunogenic antigen in Korea, it is important to define the disease group, in which patients with CDe phenotype require a transfusion of E and c-negative blood.

• Korean Journal of Clinical Laboratory Science
• /
• v.42 no.2
• /
• pp.63-70
• /
• 2010

Antibody screening and identification tests before blood transfusion are important because unexpected red antibodies can cause acute or delayed hemolytic transfusion reactions. Although a tube method was used for detecting unexpected antibodies, a column agglutination method has recently been used because of its simple procedure and a high detection of warm antibodies. This study investigated the frequency and distribution of unexpected antibodies in transfusion candidates during the recent 5 years, and transfusion characteristics in the identified cases. From January 2005 to December 2009, 46,923 sera of the cases from E hospital were screened and 98 sera were identified by the DiaMed-ID System. 272 cases (0.58%) showed positive results out of all 46,923 cases that underwent unexpected antibodies screening. Among them, unexpected antibodies were identified in 98 cases. The anti-Rh antibodies included in warm antibodies were the most frequently detected in 47 cases (47.96%). Anti-Lewis and anti-MNSs antibodies were detected in 11 cases (11.22%) and 6 cases (6.12%), respectively. Unidentified antibodies were detected in 6 cases (6.12%). Among the patients with unexpected antibodies, 43 cases (43.88%) had a history of previous transfusion. Anti-E was the most frequently detected antibody (4/14 cases, 30.77%) in the cases who had a previous history of transfusion and showed different screening results from negative to positive, This study may provide the basic data for the frequency and characteristics of red cell antibodies.

• Clinical and Experimental Pediatrics
• /
• v.59 no.2
• /
• pp.100-103
• /
• 2016

Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening medical conditions due to their religious convictions. These patients require management alternatives to blood transfusions. Erythropoietin is a glycopeptide that enhances endogenous erythropoiesis in the bone marrow. With the availability of recombinant human erythropoietin (rHuEPO), several authors have reported its successful use in patients refusing blood transfusion. However, the optimal dose and duration of treatment with rHuEPO are not established. We report a case of a 2-year-old boy with diarrhea-associated HUS whose family members are Jehovah's Witnesses. He had severe anemia with acute kidney injury. His lowest hemoglobin level was 3.6 g/dL, but his parents refused treatment with packed RBC transfusion due to their religious beliefs. Therefore, we treated him with high-dose rHuEPO (300 IU/kg/day) as well as folic acid, vitamin B12, and intravenous iron. The hemoglobin level increased steadily to 7.4 g/dL after 10 days of treatment and his renal function improved without any complications. To our knowledge, this is the first case of successful rHuEPO treatment in a Jehovah's Witness child with severe anemia due to HUS.

• Childhood Kidney Diseases
• /
• v.3 no.1
• /
• pp.104-108
• /
• 1999

Atypical hemolytic uremic syndrome associated with neuraminidase-producing Streptococcus pneumoniae usually associated with invasive infection such as fulminant pneumonia, sepsis, and meningitis and may occur earlier in lift and has a higher mortality rate than typical hemolytic uremic syndrome. We have experienced a 22-month-old female patient with hemolytic uremic syndrome associated with S. pneumoniae pneumonia and empyema. The patient was treated with ceftriaxone and washed red blood cell transfusion. As the disese course could be aggravated by the use of blood products containing anti-Tomsen-Friedenreich antigen, early recognition and sensible use of blood products such as washed RBC might lead to the improved outcome.

• Annals of Laboratory Medicine
• /
• v.38 no.6
• /
• pp.599-603
• /
• 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.

• Korean Journal of Veterinary Service
• /
• v.45 no.4
• /
• pp.269-275
• /
• 2022

Blood type in dogs is based on the antigen present on the red blood cell surface. Dog erythrocyte antigen 1 is a crucial red blood cell antigen in dogs, whereas the dog erythrocyte antigen 7 has been studied in limited dog breeds worldwide. To assess the prevalence of dog erythrocyte antigens 1 and 7 in 11 breeds in the Republic of Korea, 624 dog blood samples were examined for antigen detection. Overall, 520 dogs (83.3%) showed dog erythrocyte antigen 1 expression. The distribution varied from 50.0~100.0% according to the breed. Dog erythrocyte antigen 1-positive blood type was the highest in Chihuahua (100%), followed by Jindo dog (98.5%), and Sapsaree (95.3%). Dog erythrocyte antigen 7 was positive in 125 dogs (20.0%), and the positivity varied from 5.0~42.9% according to the breed. Dog erythrocyte antigen 7-positive blood type was the highest in Beagle (42.9%), followed by Chihuahua (37.5%), and Jindo dog (27.8%). The high prevalence of dog erythrocyte antigen 1 is because of the high proportion of Jindo dog and Sapsaree breeds that were mostly positive for the antigen. The high abundance of these breeds could be due to inbreeding and local breeding in the Republic of Korea. To our best knowledge, this study is the first to report on the prevalence of dog erythrocyte antigens 1 and 7 among various canine breeds in the Republic of Korea. The prevalence data obtained from this study may contribute to baseline information on veterinary transfusion medicine in small animal practice.

• Journal of Korean Academy of Nursing
• /
• v.29 no.3
• /
• pp.711-720
• /
• 1999

The purpose of this study was to define the content of physiological knowledge needed for clinical nursing practices. Subjects of physiology were classified into 15 areas, and each areas was further classified into subareas, resulting in a total of 194 subareas. The degree of importance of each subarea was measured with a 4-point scale. The subjects of this study were 179 nurses of two university hospitals located in Seoul and Inchon. The results were as follows : 1. The areas of physiology necessary for clinical nursing practice as a basic knowledge in the order of importance were : blood, respiratory system and renal physiology, function of the immune system, body fluid and cardiovascular system, body temperature, endocrine physiology and gastrointestinal physiology However, the degree of importance for reproductive physiology, neuro-physiology, energy and metabolism, cell and cell membrane physiology, muscular physiology and special sense was relatively low. 2. The most important content of physiology for all clinical areas in nursing was blood physiology. However, the degree of importance for each physiology area was different depending on clinical areas. 3. Subareas of physiology as a basic knowledge for clinical practice and education in nursing were blood transfusion, blood type, function of red blood cell, white blood cell and platelet, characteristics and function of hemoglobin, composition and function of plasma protein, and mechanism of blood coagulation and anticoagulation. In conclusion, areas of physiology necessary for clinical nursing practice were blood, respiratory system and renal physiology, function of immune, body fluid and cardiovascular system, body temperature, endocrine physiology and gastrointestinal physiology. However, the degree of importance for each physiology area was different depending on clinical areas In nursing.

• Journal of Chest Surgery
• /
• v.23 no.2
• /
• pp.268-274
• /
• 1990

Bleeding after cardiopulmonary bypass remains a cause for concern, requiring reexploration of the chest in approximately 3 percent of patients who have had operations on the heart. We examined the possibility that this problem might be alleviated by desmopressin acetate [DDAVP], synthetic vasopressin analogue that lacks vasoconstrictor activity. In a prospective, randomized trial, we studied the effect of intraoperative desmopressin acetate in 20 patients [the treated group 10 patients and the control group 10 patients] undergoing various cardiac operations requiring cardiopulmonary bypass. The result showed that the early postoperative [during first 24hrs] and mean postoperative blood loss [first 3 days] of the treated group were significantly reduced than the control group[447\ulcorner199ml in the treated group versus 746\ulcorner199ml in the treated group versus 746\ulcorner295 ml in the control group, p=0.014; mean\ulcornerstandard deviation and 675\ulcorner276 ml in the treated group versus 1006\ulcorner303 ml in control group, p=0.019]. The mean red-cell transfusion in first 3days were reduced in the treated group than the control group [3.3\ulcorner1.7 units vs 4.9\ulcorner1.7units, P=0.051]. There were no untoward side effects of desmopressin acetate. We conclude that the administration of desmopressin acetate can be recommended to reduce blood loss and blood conservation in patients undergoing cardiac operations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.49 no.4
• /
• pp.208-213
• /
• 2023

Objectives: Orthognathic surgery is a corrective intervention for maxillofacial deformities. Bleeding is a major concern for oral and maxillofacial surgeons. Various agents, such as hemocoagulase, tranexamic acid, and aprotinin have been developed to reduce intraoperative bleeding and transfusion requirements. Therefore, in this study we aimed to investigate the effects of hemocoagulase and tranexamic acid, as well as their simultaneous use, to reduce bleeding during orthognathic surgery. Patients and Methods: This retrospective study included patients who had undergone simultaneous orthognathic surgery of the maxilla and mandible between January 2013 and September 2022 and were classified into three groups based on drugs administered: hemocoagulase (Botropase), tranexamic acid, and a combination of both drugs. We recorded patient age, sex, weight, blood loss, and duration of surgery. Red blood cell (RBC), hemoglobin, hematocrit, and platelet levels were measured before, immediately after, and one day after surgery. Results: No statistically significant differences were found in blood loss, RBC, hemoglobin, hematocrit, or platelet levels between any of the groups. There were no differences in the drug effects between Le Fort I and bilateral mandibular sagittal split osteotomies, with or without double genioplasty. However, there were significant reductions in RBC, hemoglobin, hematocrit, and platelet levels during genioplasty. Conclusion: Tranexamic acid, hemocoagulase, and their combination had similar efficacy in patients who underwent Le Fort I and bilateral mandibular sagittal split osteotomies with and without genioplasty.

• Journal of Chest Surgery
• /
• v.42 no.4
• /
• pp.473-479
• /
• 2009

Background: Retrograde autologous priming (RAP) is known to be useful in decreasing the need of transfusions in cardiac surgery because it prevents excessive hemodilution due to the crystalloid priming of cardiopulmonary bypass circuit. However, there are also negative side effects in terms of blood conservation. We analyzed the intraoperative blood-conserving effect of RAP and also investigated the efficacy of autotransfusion and ultrafiltration as a supplemental method for RAP. Material and Method: From January 2005 to December 2007, 117 patients who underwent isolated coronary artery bypass operations using cardiopulmonary bypass (CPB) were enrolled. Mean age was 63.9$\pm$9.1 years (range 36$\sim$83 years) and 34 patients were female. There were 62 patients in the RAP group and 55 patients in he control group. Intraoperative autotransfusion was performed via the arterial line. RAP was done just before initiating CPB using retrograde drainage of the crystalloid priming solution. Both conventional (CUF) and modified (MUF) ultrafiltrations were done during and after CPB, respectively. The transfusion threshold was less than 20% in hematocrit. Result: Autotransfusions were done in 79 patients (67.5%) and the average amount was 142.5$\pm$65.4 mL (range 30$\sim$320 mL). Homologous red blood cell (RBC) transfusion was done in 47 patients (40.2%) and mean amount of transfused RBC was 404.3$\pm$222.6 mL. Risk factors for transfusions were body surface area (OR 0.01, 95% CI 0.00 $\sim$ 0.63, p=0.030) and cardiopulmonary bypass time (OR 1.04, 95% CI 1.01 $\sim$ 1.08, p=0.019). RAP was not effective in terms of the rate of transfusion (34.5% vs 45.2%, p=0.24). However, the amount of transfused RBC was significantly decreased (526.3$\pm$242.3ml vs 321.4$\pm$166.3 mL, p=0.001). Autotransfusion and ultrafiltration revealed additive and cumulative effects decreasing transfusion amount (one; 600.0$\pm$231.0 mL, two; 533.3$\pm$264.6 mL, three; 346.7$\pm$176.7 mL, four; 300.0$\pm$146.1 mL, p=0.002). Conclusion: Even though RAP did not appear to be effective in terms of the number of patients receiving intraoperative RBC transfusions, it could conserve blood in terms of the amount transfused and with the additive effects of autotransfusion and ultrafiltration. If we want to maximize the blood conserving effect of RAP, more aggressive control will be necessary - such as high threshold of transfusion trigger or strict regulation of crystalloid infusion, and so forth.