Detection of cold hemagglutination in a blood cardioplegia unit before systemic cooling of a patient with unsuspected cold agglutinin disease.

A case is described in which hemagglutination occurred intraoperatively in cold blood flushed through the blood cardioplegia delivery system from a patient with unsuspected cold agglutinin disease. On initiating cardiopulmonary bypass and then selectively cooling the perfusate in the blood cardioplegia delivery system before inducing systemic cooling, it is possible to check for cold agglutination. Routine use of this technique may be worthwhile to detect cold agglutination in vitro before systemic cooling is begun in the rare patient with unsuspected cold agglutinins.