Transfusion of Jra-positive Red Blood Cells to a Jra-negative Patient with Anti-Jra / 대한수혈학회지

ABSTRACT

Jra is a high-frequency red cell antigen, and antibodies to Jra (anti-Jra) are rarely found. The clinical significance of anti-Jra has been under debate. We report a case of a Jra negative patient having anti-Jra who was urgently transfused with Jra-positive red blood cells (RBCs) during an aortic valvuloplasty. As Jra-negative RBCs were not available, this 57 year-old female patient was transfused with six units of Jra-positive RBCs during the surgery. The hemoglobin concentration decreased from 13.0 g/dL to 7.7 g/dL due to excessive bleeding, but increased up to 13.2 g/dL after the transfusion of an additional four units of Jra-positive RBCs. A direct antiglobulin test (DAT) was positive on day 3 and day 10 after surgery. Twenty days following surgery at the outpatient clinic, the hemoglobin concentration was 10.4 g/dL and the patient had no clinical symptoms related to anemia. The DAT was negative 6 months after the transfusion. It seems to be relatively safe to transfuse Jra-positive RBCs to the patient with anti-Jra in an emergency situation.