A Case of Washed Platelet Transfusion in a Patient with History of Recurrent Transfusion Reaction / 대한수혈학회지

Anaphylactic transfusion reaction is caused by deficiency of certain protein(s) in the recipient. We report on the experience of platelet count recovery using washed platelets for transfusion in a patient who developed an anaphylactic transfusion reaction. A 50-year old male diagnosed with angioimmunoblastic T-cell lymphoma was treated with chemotherapy followed by autologous hematopoietic stem cell transplantation. Immediately after starting transfusion of apheresis platelets, he began sweating and complained of visual impairment, chest discomfort, and abdominal pain. Both systolic and diastolic blood pressures and oxygen saturation monitored by pulse oximetry were decreased. Platelet transfusion was discontinued immediately and hydrocortisone was administered, and the symptoms and signs were resolved within two hours. Laboratory test using post-transfusion blood showed no apparent evidence of hemolysis. Platelet washing procedure using normal saline three times was newly set to prevent anaphylactic reaction in the patient. Transfusions of washed platelets were performed 20 times for 60 days, and the patient showed no anaphylactic reaction during this period. He showed no evidence of immunoglobulin A, haptoglobin, C3, or C4 deficiencies. We confirmed that washed platelet transfusion is highly effective for prevention of anaphylactic transfusion reaction.

Network Computer Management System Development for Blood Transfusion in ABO-Incompatible Stem Cell Transplantation / 대한수혈학회지

BACKGROUND: The majority of patients undergoing stem cell transplantation (SCT) require a blood transfusion until the complete engraftment. Because blood transfusion rules for patients with ABO-incompatible SCT are complicated, we developed an ABO-incompatible transfusion management system (ABO-ITMS) for accurate blood transfusion and improved manageability. METHODS: A committee composed of medical doctors, technicians, and a programmer developed ABO-ITMS during the eight months from July 2013 to February 2014. The program has been linked with other databases, including clinical and laboratory databases and resulted in a new subsystem of the health information system. Server computer's operating system was Window Server 2008, and the database manager program was Oracle 11g. Programming language was ASP.Net (VBScript, C #), and the server and client computer were used to connect to the web server using a web browser. RESULTS: ABO-ITMS was designed to follow three main steps by hematologic oncology clinic, laboratory physician, and blood bank. In the first step, a hematologic-oncology clinic doctor inputs SCT recipients' data and appropriate ABO group for each phase of post-transplantation. Laboratory physician enters the isoagglutinin titer and ABO group at the second step. Finally, blood bank workers enter the results of type, screening, and antibody identification. The patient's SCT information and the previous immunohematologic test results are shown on the screen. CONCLUSION: ABO-ITMS can replace the existing complicated system and workflow. ABO-ITMS will contribute to reducing medical error and improving quality of SCT recipient care.