Allanki Surekha Devi
Department of Transfusion Medicine, Global Hospitals, Hyderabad 500004, India.
Case Rep Transplant. 2011;2011:250674. doi: 10.1155/2011/250674. Epub 2011 Jun 30.
Red blood cell alloantibodies can cause severe delayed hemolysis, despite immunosuppression which they receive posttransplantation. A female patient with Hepatitis C-related chronic liver disease reported to our center for liver transplantation. During preoperative evaluation, she was found to have significant red blood cell alloantibodies which gave rise to problems during pre transfusion compatibility test. Stringent measures were taken by the transplant team to minimize blood loss during surgery. It was decided to have lower transfusion trigger for red cell transfusion, and blood conservation was done by intraoperative red cell salvage and use of antifibrinolytic agent. During immediate postoperative period, she developed drug-related immune hemolytic anemia. Presence of both warm autoantibodies and alloantibodies posed a big challenge for us to get cross-match compatible blood. She received 22 units of crossmatch compatible red cell transfusions during her hospital stay, which was uneventful. Hence, we reported this case.
尽管接受了移植后的免疫抑制治疗，但红细胞同种抗体仍可导致严重的迟发性溶血。一名患有丙型肝炎相关慢性肝病的女性患者到我们中心进行肝移植。在术前评估中，发现她有显著的红细胞同种抗体，这在输血前相容性检测中引发了问题。移植团队采取了严格措施以尽量减少手术期间的失血。决定降低红细胞输血的触发阈值，并通过术中红细胞回收和使用抗纤溶药物来进行血液保护。在术后即刻，她出现了药物相关的免疫性溶血性贫血。温抗体和同种抗体的同时存在给我们获取交叉配型相合的血液带来了巨大挑战。她在住院期间接受了22单位交叉配型相合的红细胞输血，过程顺利。因此，我们报告了该病例。
