Korean J Blood Transfus.
2013 Apr;24(1):48-57.
Effect of the Least Incompatible Blood Transfusion in Patients with Panagglutination (Least Incompatible Blood Transfusion)
- Affiliations
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- 1Department of Laboratory Medicine, Kosin University College of Medicine, Busan, Korea.
- 2Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea. hyunok1019@yuhs.ac
- 3Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Abstract
- BACKGROUND
In patients who had serum autoantibody that reacted with all screening red blood cells (panagglutination), waiting for compatible blood is likely to delay a needed transfusion. In some cases of severely diminished hemoglobin counts, the least incompatible blood may be transfused. However, the least incompatible transfusion therapy is challenged by the presence of unexpected antibody in patient's serum, which may cause a transfusion reaction. The aim of this study was to evaluate the effect of the least incompatible transfusion on clinical outcomes in patients with panagglutination.
METHODS
We conducted a retrospective study of 49 patients with panagglutination on an unexpected antibody screening test between January 2006 and July 2010. In 36 patients having the least incompatible blood transfusion, changes in hemoglobin and lactate dehydrogenase (LD) values before and after transfusion were analyzed. One year mortality after initial need for transfusion was documented.
RESULTS
In all 36 patients who underwent transfusion, hemoglobin values showed an increase of 1.2 (0.0~3.0) g/dL per unit without occurrence of acute transfusion reactions indicated by an increase in the LD level. The least incompatible transfusion did not show an association with increased all-cause mortality.
CONCLUSION
As an alternative to the time consuming process of alloantibody detection, patients with severe anemia can be effectively transfused with "least incompatible units" in an emergency clinical setting without experiencing acute transfusion reactions.
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