Badawi Maha A, Al-Wassia Heidi
Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Blood Transfusion Services Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Transfusion. 2023 Feb;63 Suppl 1:S28-S32. doi: 10.1111/trf.17204.
Hemolytic disease of the fetus and newborn (HDFN) is a challenging condition that may necessitate the need for intrauterine or neonatal transfusion. The ability to provide compatible blood depends on antibody identification and antigen prevalence. We describe the case of a newborn that was affected by HDFN secondary to a high-prevalence antigen of unknown specificity.
A 29-year-old mother underwent emergency cesarean section for fetal distress. The newborn had severe anemia and hyperbilirubinemia. Antibody screening and identification on maternal plasma revealed pan reactivity with negative autocontrol. The cord sample had the same pattern with positive Direct Antiglobulin Test. Incompatible group O red blood cells were transfused to the newborn with no complications.
Testing the maternal sample at a reference laboratory revealed the presence of anti-U at a high titer.
In life-threatening conditions, it may be necessary to transfuse incompatible units. In patients who require transfusion in the presence of an identified antibody against a high-prevalence antigen, sources for rare blood should be explored. These include autologous donations for adults, collecting blood from relatives (including mothers), and fresh or frozen units from rare donors through rare donor registries.
胎儿及新生儿溶血病（HDFN）是一种具有挑战性的病症，可能需要进行宫内或新生儿输血。提供相容血液的能力取决于抗体鉴定和抗原流行率。我们描述了一例因特异性未知的高流行率抗原导致HDFN的新生儿病例。
一名29岁的母亲因胎儿窘迫接受了急诊剖宫产。新生儿患有严重贫血和高胆红素血症。对母亲血浆进行抗体筛查和鉴定显示与阴性自身对照呈全反应性。脐带样本具有相同模式且直接抗球蛋白试验呈阳性。给新生儿输注了不相容的O型红细胞，未出现并发症。
在参考实验室对母亲样本进行检测发现存在高滴度的抗U抗体。
在危及生命的情况下，可能有必要输注不相容的血液单位。对于存在针对高流行率抗原的已鉴定抗体且需要输血的患者，应探索稀有血液来源。这些来源包括成人的自体献血、从亲属（包括母亲）采集血液，以及通过稀有献血者登记处从稀有献血者获取新鲜或冷冻的血液单位。
