Resolution by erythrocytapheresis of the exposure of an Rh-negative person to Rh-positive cells: an alternative treatment.

Acute trauma with severe bleeding caused the unavoidable transfusion of Rh-positive red cells (RBCs) to a young, childless, Rh-negative woman during surgery. Of the 10 units of RBCs given, 6 were Rh positive. An alternative treatment for large-volume exposure involves the removal of some of the Rh-positive cells transfused at a time when the patient's condition could not be jeopardized by the shortage of Rh-negative RBCs. It is believed that the combination of erythrocytapheresis followed by Rh immune globulin treatment was successful, when immunoprophylaxis alone might not have been. It is strongly recommended that partial RBC exchange for the removal of the unwanted RBCs be considered in addition to Rh immune globulin treatment in cases of large-volume exposure such as the one presented.