Delayed Hemolytic Transfusion Reaction Caused by Anti-Jkb Antibody in a Renal Transplant Recipient / 대한신장학회잡지

We report a case of 46-year-old women who suffered from delayed transfusion hemolytic anemia due to anti-Jkb antibody after renal transplantation. The patient had been treated with hemodialysis and had a past history of multiple transfusion. On the second postoperative day, she received 2 units of packed red cell. During transfusion, she complained of mild chest tightness only, but 10 days later, anemia of unknown origin developed. Irregular antibody was found in her serum and identified as anti- Jkb antibody. Together with other serologic findings, she was diagnosed as delayed hemolytic transfusion reaction due to anti -Jkb antibody. We thought that this reaction might be the amnestic response to previous exposure during delivery or remote multiple transfusion. Our patient responded to steroid and plasmapheresis and recovered without severe hemolytic transfusion reaction. In conclusion, antibody screening tests and identification test might be considered as a routine pretransfusion test for all renal recipients for safe transfusion practices.

Two Cases of Severe Hemolytic Transfusion Reactions Caused by Anti-Jkb Antibody / 대한수혈학회지

We report two patients who suffered from hemolytic transfusion reactions due to anti-Jkb antibody: one showed acute- and the other showed delayed-type hemolysis. The first patient was a 40-year-old man who suffered from epilepsy after the operation for arteriovenous malformation 16 years ago. He received five units of red blood cells (RBC) after right temporal lobectomy. On the fifteenth postoperative day, fever and chill developed during transfusion of one unit of packed RBC, followed by dark urine and oliguria. The polyethylene glycol-Coombs test and enzyme test revealed anti-Jkb antibody which had not been detected on the pretransfusion specimen. The second patient was a 41-year-old man who was admitted for the reoperation of the prosthetic mitral valve. Because hemoglobin was 5.9g/dL at admission, he received five units of packed RBCs. Oliguria and laboratory findings consistent with hemolytic anemia were observed from the third day of transfusion. Anti-Jkb antibody was detected on antiglobulin phase. Both patients developed acute renal failure (ARF) and hemodialysis with conservative management were done. They finally recovered from ARF without any residual complications. Implementation of more sensitive pretransfusion tests should be considered to prevent rare, but serious hemolytic transfusion reactions.