Exchange transfusion of least incompatible blood for severe hemolytic disease of the newborn due to anti-Rh17.
HDN attributed to the rare Rh variants has become more and more significant caused by anti-D, but the compatible blood is usually very difficult to obtain when exchange transfusion is required. We treated a 10-hour neonate of O, D + C + c - E - e+ blood group with severe HDN due to anti-Rh17 with least incompatible blood typed O, D + C - c + E + e-. The neonatal hemolysis was relieved obviously and bilirubin was reduced gradually after exchange transfusion. The infant was discharged in good health 13 days after birth with 135.0 g/L, 28.0 micromol/L and 10.7 micromol/L of Hb, total bilirubin and direct bilirubin, respectively. No sequelae were observed in a three-year follow-up. The result suggesting that the least incompatible blood is an alternative choice for exchange transfusion in severe HDN due to anti-Rh17 in case that Rh17 antigen-negative blood is unavailable.
Li
Bi-juan
BJ
Department of Blood Transfusion, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008. jyjysh@163.com
Jiang
Yuan-jun
YJ
Yuan
Fen
F
Ye
Hong-xing
HX
D000328:Adult; D016913:Blood Component Transfusion / Q000379:methods*; D001787:Blood Group Incompatibility / Q000188:drug therapy / Q000276:immunology*; D001788:Blood Grouping and Crossmatching; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D015160:Hydrops Fetalis / Q000276:immunology / Q000628:therapy*; D051556:Hyperbilirubinemia, Neonatal / Q000209:etiology / Q000532:radiotherapy / Q000628:therapy; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D007518:Isoantibodies / Q000276:immunology*; D047589:Leukocyte Reduction Procedures; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D010949:Plasma; D011247:Pregnancy; D012203:Rh Isoimmunization; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D018029:Rho(D) Immune Globulin; D014467:Ultraviolet Therapy; D055815:Young Adult
D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D007518:Isoantibodies; C061961:RHO(D) antibody; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin; C026410:Rho(D) antigen; D008775:Methylprednisolone