Aoyagi S, Yamashita M, Oryoji A, Kosuga K, Oishi K, Nakamura Y
Second Department of Surgery, Kurume University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Dec;38(12):2416-20.
Two operated cases with erythrocyte antibodies were reported. In the first case who required the second open heart operation for mitral stenosis, delayed hemolytic transfusion reaction by erythrocyte antibodies was recognized. The direct and indirect Coombs' tests were negative and the erythrocyte antibodies were not detected preoperatively. Massive blood transfusion during perioperative period precipitated secondary immunoreaction and reproduction of antibodies. An anti-c antibody and anti-E antibody were detected by the serologic studies on the 11th and 16th postoperative day. In the second case, stenotic mitral valve was replaced without homologous blood transfusion, because anti-C antibody was detected preoperatively. We believe that open heart operations without blood transfusion should be done, whenever possible, it should be kept in mind that delayed hemolytic transfusion reaction by erythrocyte antibody may occur after blood transfusion.
报道了两例有红细胞抗体的手术病例。第一例因二尖瓣狭窄需进行第二次心脏直视手术,术中发现了由红细胞抗体引起的迟发性溶血性输血反应。直接和间接抗人球蛋白试验均为阴性,术前未检测到红细胞抗体。围手术期大量输血引发了继发性免疫反应和抗体再现。术后第11天和第16天的血清学研究检测到了抗-c抗体和抗-E抗体。第二例患者,由于术前检测到抗-C抗体,在未进行同种异体输血的情况下置换了狭窄的二尖瓣。我们认为,只要有可能,就应进行无输血的心脏直视手术,同时应牢记输血后可能会发生由红细胞抗体引起的迟发性溶血性输血反应。