ABSTRACT
A retrospective analysis was conducted on 20 D(-) liver transplant (LT) recipients transfused with D(+) RBCs perioperatively and screened for RBC antibodies between 2 and 6 months later. None developed anti-D detectable by the indirect antiglobulin test. Two patients produced weak anti-D that reacted only with papain-treated RBCs at 10 and 11 days without any sign of immune haemolysis. Antibodies became quickly undetectable. These data suggest an unusual pattern of alloimmunization in LT recipients with rapid, weak and transient antibody response and support the safety of transfusing D(+) RBCs in most of D(-) patients during LT surgery.
Subject(s)
Coombs Test , Liver Transplantation , Rho(D) Immune Globulin/blood , Adult , Blood Transfusion , Erythrocytes/cytology , Erythrocytes/immunology , Erythrocytes/metabolism , Female , Hemolysis , Humans , Isoantibodies/blood , Male , Middle Aged , Papain/metabolism , Retrospective Studies , Rho(D) Immune Globulin/immunology , Young AdultABSTRACT
In response to the needs of the Home Medical Services a project was set up in the Hemobiology Transfusion Service of Beaujon Hospital. The objective of this project was to avoid the difficult transfer of patients who were receiving for the most part palliative treatment. This required strict organization between consultants, haemobiologist physicians and healthcare personnel. The exclusion criteria have been respected (geographical distance, state of the non-compensated clinic, absence of family/patient cooperation). During the last 4 years of activity, 1,662 transfusions have been carried out on 757 patients, of which 80% had hematological affections, 10% solid tumours and 10% AIDS affections. 5,548 blood components have been transfused (2,104 red cell concentrates, 3,152 pooled platelet concentrates and 292 apheresis platelet concentrates). Thirty-one minor incidents were observed representing a prevalence of 0.56%. The poor codification of cases has slowed down the development of this project. The centralization of requests with coordination by the haemobiologist physicians within the Paris region should allow a guaranteed response to the numerous requests.
