title: [Antibodies against high frequency antigen and total knee replacement].
abstract: We report the perioperative management of a woman expressing an antibody against high frequency red cell antigen (anti-Kel4 antibody anti-kpb) who was scheduled for a total knee replacement. A specific strategy was designed to afford this major orthopedic surgery, considering specially the occurrence of unusual bleeding higher than the average bleeding assessed in our hospital in this indication. The transfusion of incompatible red cells may be responsible for acute hemolytic reaction. An autologous transfusion program, including cryopreservation, erythropoietin and iron support, was provided. Three autologous red cells units were collected before surgery. Compatible homologous red cells units were also available at the French bank for rare blood groups. We report logistical and medical problems that have occurred during the perioperative period.
authors: Service d'anesthésie-réanimation, hôpital d'instruction des armées Percy, 101 avenue Henri-Barbusse, Clamart cedex, France. jeanvivien.schaal@yahoo.fr
authors: J-V
authors: JV
authors: Schaal
authors: G
authors: G
authors: De Saint Maurice
authors: B
authors: B
authors: Clavier
authors: S
authors: S
authors: Ausset
authors: B
authors: B
authors: Lenoir
mesh_terms: D000369:Aged, 80 and over; D000941:Antigens / Q000276:immunology*; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001793:Blood Preservation; D001804:Blood Transfusion, Autologous; D015925:Cryopreservation; D017707:Erythrocyte Transfusion; D004912:Erythrocytes / Q000276:immunology*; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D010347:Patient Care Planning; D011994:Recombinant Proteins
chemical_list: D000941:Antigens; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron