Lab Med Online.  2022 Jul;12(3):205-208. 10.47429/lmo.2022.12.3.205.

Transfusion of the Least-incompatible Blood with Intravenous Immunoglobulin and Steroid to a Patient with Anti-Fy^a

• Yu J
• Kim JS
• Yang JJ
• Chung Y
• Kim H
• Hwang SH
• Oh HB
• Youk HJ
• Ko DH

• KMID: 2538607
• DOI: http://doi.org/10.47429/lmo.2022.12.3.205

Abstract

Antibody to high-incidence antigens is one of the most challenging issues in transfusion medicine. Transfusion of the least-incompatible red blood cell (RBC) unit is standard practice, which may sometimes result in unfavorable outcomes. In this case, we attempted to transfuse the least-incompatible blood with intravenous immunoglobulin (IVIG) and steroid to a patient with anti-Fy^a. A 39-year-old female patient with liver cirrhosis was admitted for nausea and vomiting. Her hemoglobin level was 5.5 g/dL. Antibody identification tests showed anti-E, c, Jk^b, and Fy^a alloantibodies. As Fy^a is a high-incidence antigen in Korea, she was transfused with 8 least-incompatible RBC units containing the Fy^a antigen in conjunction with IVIG and methylprednisolone. Although evidence of mild hemolysis was found in laboratory tests, there were no significant side effects. To the best of our knowledge, this is the first report of a transfusion strategy for a patient with anti-Fy^a.

Keyword

Duffy blood group system; Intravenous immunoglobulins; Red blood cell transfusion; Hemolytic transfusion reaction

Figure

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  Fig. 1 Laboratory data during the patient’s admission period. Dashed and solid arrows indicate the day when transfusion of incompatible and compatible blood was performed, respectively. *This arrow indicates 3 episodes of transfusion of compatible blood. Abbreviations: HD, hospital day; LD, lactate dehydrogenase; Hb, hemoglobin.

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