ABSTRACT
Red blood cell transfusions have been associated with the risk of transfusion transmitted infections, and inappropriate transfusions may have an adverse effect on the patient's clinical course. The laboratory information system was used to examine the distribution of the hemoglobin level before transfusion and to use it as a basis for evaluating the appropriateness. A program was developed for assessing the hemoglobin level that was checked within five days before a red blood cell transfusion. The hemoglobin level was analyzed according to each clinical department and the site where the transfusion had been done from Jun to Dec 2018. A total of 10,520 units of red blood cells were transfused, and leuko-reduced units accounted for 2,225 units (21.2%). The hemoglobin measurements were taken in all units within five days. The median hemoglobin level before the transfusion was 7.9 g/dL. A significant difference in the hemoglobin level (P<0.0001) was observed among clinical departments and transfusion sites. The median hemoglobin level in cardiology was significantly higher than the other medical sub-departments. The hemoglobin level was significantly higher in the operating room (10.3 g/dL) than in the hemodialysis room (7.15 g/dL). The difference in the distribution of the hemoglobin level before a transfusion may be used as data for communication with the clinical department.
ABSTRACT
Changes in autoantibodies with mimicking specificity for Rh antigens are quite rare. Here, we report a 73-year-old male patient with hepatocellular carcinoma that showed changes in the autoantibodies with mimicking specificity. He was admitted to our hospital with mental alterations and hypoglycemia. The antibody identification test for RBC transfusion showed a pattern of agglutination, suggesting anti-E alloantibody and anti-c autoantibody. The patient was then diagnosed with hepatocellular carcinoma, and after 18 months, the antibody identification test showed a different pattern of agglutination, suggesting anti-E alloantibody and anti-C autoantibody. We recommend a careful evaluation to make sure an appropriate transfusion is performed when encountering fluctuating autoantibodies with mimicking specificity.