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Long‐term in vivo survival of Rh(D)‐negative donor red cells in a patient with anti‐LW
Author(s) -
Chaplin H.,
Hunter V. L.,
Rosche M. E.,
Shirey R. S.
Publication year - 1985
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1985.25185116500.x
Subject(s) - medicine , red cell , in vivo , antibody , red blood cell , surgery , gastroenterology , andrology , immunology , biology , microbiology and biotechnology
The present study documents immediate and long‐term survival of crossmatch‐incompatible Rh(D)‐negative donor red cells in a patient with anti‐LW. A 67‐year‐old group A Rh(D)‐positive man was admitted for urgent coronary artery bypass surgery. The direct antiglobulin test (DAT) was weakly positive in two of five laboratories. His serum contained anti‐LW (two laboratories); his red cells were LW negative (three antisera). Two siblings were LW‐positive. Surgery was delayed, and 3 ml Rh(D)‐negative crossmatch‐incompatible red cells stored in citrate‐phosphate‐dextrose‐adenine‐one were labeled with 25 μCi of 51 Cr and injected. Immediate survival was approximately 100 percent with 92 percent survival at 20 hours. Six daily blood samples showed a decreased red cell lifespan, (T ½ = 14 days). Because of medical complications, 4 units of Rh(D)‐negative crossmatch‐incompatible blood were then transfused without clinical or hemolytic reaction. The anti‐ IgG DAT became stronger. In vivo survival of the remaining 51 Cr‐RBCs became normal (T ½ 28 days over the succeeding 20 days). Following transfusion, no change in serum antibody strength was demonstrated by double‐blind titration of seven coded samples. The observations support modest reduction of lifespan for 3 ml of LW‐positive red cells, but normal survival following subsequent transfusion of approximately 700 ml of LW‐positive red cells.