[A delayed hemolytic transfusion reaction due to irregular antibodies with an anti-Kidd(a) specificity].
METHODS
A 56-year-old woman was admitted for replacement of a previously implanted right hip prosthesis which had become loose (no infection). She limped painfully on a shortened leg whose mobility was markedly impaired. At the site of the previous operation the pelvis was lower by about 2 cm; the scar looked well healed.


METHODS
Routine laboratory tests were normal except for moderately raised erythrocyte sedimentation rate (18/ 27 mm). There was complete loosening of the prosthesis on X-ray.


METHODS
Intraoperative bleeding from a branch of the inferior gluteal artery required blood transfusion and further erythrocyte infusions became necessary. Jaundice developed on the 4th postoperative day and 7 days later the direct Coombs test was positive with demonstrable agglutination. Free irregular erythrocytic anti-Kidd(a) (anti-jk[a]) antibodies were found in the serum. To counteract the delayed haemolytic transfusion reaction, exclusively jk(a)-negative erythrocytes were infused. The jaundice gradually disappeared and the bilirubin values became normal.


CONCLUSIONS
Jaundice and signs of haemolysis after erythrocyte transfusion may be due to delayed transfusion reaction and should be investigated with the direct Coombs test.
Mörsdorf
S
S
Abteilung für klinische Hämostaseologie und Transfusionsmedizin, Universitätskliniken des Saarlandes, Homburg/Saar.
Fritsch
E
E
Wagner
B
B
Seyfert
U T
UT
Wenzel
E
E
D000906:Antibodies / Q000097:blood*; D000918:Antibody Specificity; D019644:Arthroplasty, Replacement, Hip; D001804:Blood Transfusion, Autologous / Q000009:adverse effects; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D006461:Hemolysis / Q000276:immunology*; D006801:Humans; D007667:Kidd Blood-Group System / Q000276:immunology*; D008875:Middle Aged; D010949:Plasma / Q000276:immunology*; D017713:Platelet Transfusion / Q000009:adverse effects*; D011182:Postoperative Care / Q000009:adverse effects; D012086:Reoperation
D000906:Antibodies; D007667:Kidd Blood-Group System