Double volume exchange transfusion for ABO incompatible liver transplantation in paediatric patients: intraoperative and preoperative approach.
Double volume blood exchange transfusions (DBVET) were used to reduce the serum antibody levels in six paediatric patients receiving ABO incompatible hepatic allografts. In four patients, the exchange transfusions took place on the ward prior to surgery. In three of these four patients who had titres measured, the anti-A IgM titres fell from 1024 to 64, 64 to 8, and 128 to 16, respectively. The anti-A IgG titres fell from 32 to 16 and 512 to 64 in two patients, but rose from 16 to 32 in the third. In two patients DBVET were performed intraoperatively using a rapid infusion device. The IgM titres fell from 256 to 32 and 64 to 1, respectively, and the IgG titres fell from 16 to 4 and 2 to 0. Intraoperative DBVET can acutely and effectively reduce blood group antibodies. Intraoperative DBVET may reduce graft ischaemia time and allow red blood cell salvage.
Beebe
D S
DS
Department of Anesthesiology, University of Minnesota Medical School, Minneapolis 55455, USA.
Peña
A
A
Payne
W
W
Belani
K G
KG
D000017:ABO Blood-Group System / Q000276:immunology; D000906:Antibodies / Q000097:blood; D001787:Blood Group Incompatibility / Q000628:therapy*; D001804:Blood Transfusion, Autologous; D001810:Blood Volume; D002423:Cause of Death; D002648:Child; D017707:Erythrocyte Transfusion; D005078:Exchange Transfusion, Whole Blood / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007223:Infant; D007260:Infusion Pumps; D007430:Intraoperative Care; D007511:Ischemia / Q000503:physiopathology; D016031:Liver Transplantation; D008297:Male; D011300:Preoperative Care; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
D000017:ABO Blood-Group System; D000906:Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M