Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 7-8, Pages: 518-522
https://doi.org/10.2298/SARH1108518J
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Transfusion management of patients with alloanti-Gerbich antibodies: Case report
Jovanović Radmila (Zavod za transfuziju krvi Vojvodine, Novi Sad)
Bujandrić Nevenka (Zavod za transfuziju krvi Vojvodine, Novi Sad)
Lisulov Slobodanka (Zavod za transfuziju krvi Vojvodine, Novi Sad)
Bogdanović Sanja (Zavod za transfuziju krvi Vojvodine, Novi Sad)
Introduction. Transfusion management of patients who are alloimmunized
against high-prevalence erythrocyte antigens is often problematic. Strategy
management depends, not only on the specific clinical circumstances of the
patient, but also on the acceptable time frame. In patients without
clinically significant antibody incompatible transfusion it may be less
harmful than delaying medical intervention. Case Outline. We report a
57-year-old female from Libya, blood group O, RhD-positive, who was treated
at the Institute of Cardiovascular Diseases of Vojvodina. At the Blood
Transfusion Institute of Vojvodina, during pretransfusion testing an IgG
alloantibody of unknown specificity was determined. A total of 200 blood
units (O, RhD-positive) were crossmatched, but positive reactions indicating
that the donor units were incompatible for that specific patient. By testing
the patient’s family members in Tripoli, six compatible blood units were
found and applied during and after surgery. Due to the deterioration of the
patient’s condition a rapid transfusion was required; however cross-match
compatible blood was not available. After a biological crossmatch to predict
the clinical significance of this antibody, 12 units of erythrocytes with the
lowest positive cross-match reactions, were transfused to the patient without
any adverse effects. Good tolerance of the units suggested that the present
antibodies were not clinically significant. Later on, a rare alloantibody
directed to the high frequency Gerbich blood group antigens was identified by
the Foundation Central Laboratory, Blood Transfusion Service in Bern,
Switzerland. Conclusion. In cases of emergency patients with alloantibodies
against high frequency Gerbich, when autologous or compatible alogenous
transfusion is unavailable, blood with the lowest positive cross-match
reaction could be transfused if the biological cross-match is negative.
Formation of a national register of donors with rare blood groups and their
connection with international registers is of crucial significance in the
management of patients requiring antigen negative blood otherwise unavailable
from routine blood banks.
Keywords: blood group antigens, isoantibodies, blood component transfusion
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