Blood Group Incompatibility ; complications ; Erythroblastosis, Fetal ; etiology ; Humans ; Infant, Newborn ; MNSs Blood-Group System ; immunology ; Male

Liver transplantation is the only curative therapy for patients with end-stage liver disease. The high success rate and the increasing demand for the transplantation sometimes calls for ABO-compatible but nonidentical blood group orthotopic liver transplantation (OLT), which affords the opportunity to the production of antibody to red blood cells. Hemolytic anemia usually occurs 1 to 2 weeks after transplantation. Although mild in most patients, it can be life-threatening. Until now, a few cases showing hemolytic anemia due to donor ABO antibody formation after ABO-nonidentical OLT have been reported. In the reported cases of hemolytic anemia, most ABO-nonidentical OLT cases were O-to-A, but few reports are available on this subject with O-to-B ABO- nonidentical OLT. Herein, we report the experience with hemolysis after ABO-nonidentical OLT in a group O donor into a group B recipient and the successful treatment with transfusion of washed group O red blood cells and 60 mg dose of prednisolone for 3 days.
*ABO Blood-Group System ; Adult ; Anemia, Hemolytic/*etiology/therapy ; Blood Group Incompatibility/*complications ; Erythrocyte Transfusion/adverse effects ; Glucocorticoids/*administration & dosage ; Humans ; *Liver Transplantation ; Male ; Prednisolone/*administration & dosage

OBJECTIVETo retrospectively study the impacts of ABO incompatibility on early outcome after single unit unrelated cord blood transplantation（UCBT）, such as cumulative incidence of engraftment, incidence of acute graft- versus- host disease （aGVHD） and 180- day transplant- related mortality（TRM）.

METHODS208 patients underwent single unit UCBT from April 2008 to October 2014 were analyzed, included 99 ABO- identical, 60 minor, 38 major and 11 bidirectional ABO- incompatible recipients. All the patients received intensified myeloablative conditioning, and a combination of cyclosporine A and mycophenolate mofetil was given for GVHD prophylaxis.

RESULTSCumulative incidences of neutrophil engraftment, platelet recovery, erythroid lineage reconstitution, Ⅱ-Ⅳ aGVHD, Ⅲ-Ⅳ aGVHD and 180- day TRM showed no significant difference among the patients receiving ABOidentical, minor, major, and bidirectional UCBT（all P>0.05, respectively）. What's more, none of the patients developed pure red- cell aplasia（PRCA）after UCBT. Group A donor and a group O recipient patients didn't appeared to influence the clinical results when compared with others（all P>0.05, respectively）.

CONCLUSIONPatients receive ABO- incompatible UCBT may not develop PRCA. The presence of ABO- incompatibility did not influence the hematopoietic reconstitution, the incidence of aGVHD and 180-day TRM in this cohort. There is not support for the need to regard ABO-compatibility as an UCB-graft selection criterion.

ABO Blood-Group System ; Blood Group Incompatibility ; Cord Blood Stem Cell Transplantation ; adverse effects ; Cyclosporine ; therapeutic use ; Graft vs Host Disease ; complications ; Humans ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; Red-Cell Aplasia, Pure ; complications ; Retrospective Studies ; Tissue Donors ; Transplantation, Homologous

Jr(a) is a high-frequency antigen found in all ethnic groups. However, the clinical significance of the anti-Jr(a) antibody has remained controversial. Most studies have reported mild hemolytic disease of the newborn and fetus (HDNF) in Jr(a)-positive patients. Recently, fatal cases of HDNF have also been reported. We report the first case of HDNF caused by anti-Jr(a) alloimmunization in twins in Korea. A 33-yr-old nulliparous woman with no history of transfusion or amniocentesis was admitted at the 32nd week of gestation because of vaginal bleeding caused by placenta previa. Anti-Jr(a) antibodies were detected in a routine laboratory examination. An emergency cesarean section was performed at the 34th week of gestation, and 2 premature infant twins were delivered. Laboratory examination showed positive direct antiglobulin test and Jr(a+) phenotype in the red blood cells and the presence of anti-Jr(a) antibodies in the serum in both neonates. The infants underwent phototherapy for neonatal jaundice; this was followed by conservative management. They showed no further complications and were discharged on the 19th postpartum day. Preparative management to ensure the availability of Jr(a-) blood, via autologous donation, and close fetal monitoring must be performed even in cases of first pregnancy in Jr(a-) women.
Adult ; Blood Group Antigens/immunology ; *Blood Group Incompatibility ; Diseases in Twins/diagnosis/*immunology ; Erythroblastosis, Fetal/*diagnosis/immunology ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Isoantigens/immunology ; Jaundice, Neonatal/complications/immunology/therapy ; Male ; Phenotype ; Phototherapy ; Pregnancy ; Pregnancy Complications, Hematologic/diagnosis/*immunology ; Twins

OBJECTIVESTo study clinical characteristics and outcome of pure red cell aplasia (PRCA) following major ABO-incompatible allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSVariables including sex, age, stem cell source, granulocyte engraftment time, blood transfusion and isoagglutinin type against donor RBC were analyzed to identify risk factors for the development of PRCA.

RESULTSTwelve of 100 patients received major ABO-incompatible allo-HSCT developed PRCA, with out any effect on incidence of aGVHD and CMV infection. ABO blood groups of recipient/donor pairs of these twelve PRCA patients were O/A in nine, B/A in one and O/B in two. Patients with anti-A isoagglutinins against donor RBC developed PRCA more frequently than those with anti-B (10/49 vs 2/49). Median duration to the recovery of erythropoiesis tended to be longer in patients with PRCA (PRCA vs non-PRCA, 203.5 vs. 76 days, P < 0.05 ). Median durations to the disappearance of incompatible isoagglutinins tended to be longer in patients with PRCA (PRCA vs. non-PRCA, 150.5 vs. 60 days,P <0.05) and in those with anti-A isoagglutinins (anti-A vs anti-B, 90 vs 55 days, P < 0.05).

CONCLUSIONABO blood group of O/A in recipient/donor pair was the only high risk factor for PRCA after major ABO-incompatible allo-HSCT.

ABO Blood-Group System ; immunology ; Blood Group Incompatibility ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Postoperative Complications ; etiology ; therapy ; Prognosis ; Red-Cell Aplasia, Pure ; etiology ; therapy ; Retrospective Studies ; Risk Factors

The objectives of study was to investigate the clinical characteristics and risk factors of pure red cell aplasia (PRCA) following ABO-incompatible allogeneic hematopoietic stem cell transplantation (allo-HSCT). The clinical data of 72 patients receiving ABO-incompatible allo-HSCT were collected and retrospectively studied. The clinical parameters including sex, age, granulocyte engraftment time and blood transfusion were analyzed for the exploration of risk factors resulting in development of PRCA. The results indicated that 4 out of 72 patients receiving ABO-incompatible allogeneic hematopoietic stem cell transplantation developed PRCA, 3 cases out of these patients were ABO-major incompatible, 1 case was Bi-direction incompatible, nor any effect of PRCA was observed on incidence of GVHD and CMV infection. In conclusion, PRCA is a major complication of patients receiving ABO-incompatible allo-HSCT, while ABO blood group of O/A in recipient/donor pair may be the major high risk factor for PRCA after ABO-mismatched allo-HSCT.
ABO Blood-Group System ; immunology ; Adolescent ; Adult ; Blood Group Incompatibility ; complications ; Female ; Hematologic Neoplasms ; therapy ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Middle Aged ; Red-Cell Aplasia, Pure ; etiology ; immunology ; Transplantation, Homologous ; Young Adult

Deliberate hypotension reduces bleeding in a wound, there by providing the surgeon with both better visibility and technical freedom for a more definitive dissection and minimizes the need for blood replacement, thereby reducing the risks of transfusion reactions, hepatitis, and acquired immune deficiency syndrome (AlDS). anesthesia With major development in surgery for spine problems in this century there are many reports and studies about the pathophysiology of spine, cord hemodynamics and functional monitoring about spinal cord activity during induced hypotension. Although by the comparative studies of vasodilator deliberate hypotension with nitroprusside was found to induce a reliable and rapid drop in blood pressure, we have found some different responses to the chosen vasodilators between the older, less active groups and the healthy, robust, and physically active groups. In this study we evaluated the hypotensive anesthesia for 42 cases of spinal surgery-posterior stabilization, spinal fusion, laminectomy, osteotomies, and discectomy-performed at Kwangju Christian Hoispital from May 1987 to May 1988. The result of our study was as follows: 1) Halothane and enflurane were used as primary anesthetics in 31 and ll cases respectively. Nitroprusside, hydralazine and both of this two vasodilatora were supplementarily used for inducing hypotensin in 14, 16 and 5 cases, respectively. 2) Although in many paient particularly in the older and less active groups, the combination of halogenated anesthetics and hydralazine are sufficient to produce appropriate operating conditions, in healthy, robust and physicaly active groups nitroprusside or even the combination of two vasodilators are required. 3) The mean arterial pressure of the lowest blood pressure in the induced hypotension was 60.5+/-11.6 mmHg. 4)The mean blood loss and blood replacement was 1242.2+/-769 ml and 925.4+/-854 ml respectively. 5) In the intraoperative period gas analysis arterial CO2 tension was 34.2+/-6.6mmHg and other values was within normal limit. 6) There was no significant perioperative and postoperative complication due to induced hypotension itself. In conclusion, the technique of using induced hypotension with inhalation anesthetics supplemented by nitroprusside, hydralazine, or both is safe and useful one to use in performing surgery for spinal problems.
Acquired Immunodeficiency Syndrome ; Anesthesia* ; Anesthetics ; Anesthetics, Inhalation ; Arterial Pressure ; Blood Group Incompatibility ; Blood Pressure ; Enflurane ; Freedom ; Gwangju ; Halothane ; Hemodynamics ; Hemorrhage ; Hepatitis ; Hydralazine ; Hypotension ; Intraoperative Period ; Laminectomy ; Nitroprusside ; Osteotomy ; Postoperative Complications ; Spinal Cord ; Spinal Fusion ; Spine ; Vasodilator Agents ; Wounds and Injuries

This study was aimed to investigate various factors influening erythrocyte recovery following ABO-incompatible allogeneic HSCT. 157 patients following ABO-incompatible allogeneic HSCT were selected for the investigation. Cox regression analysis were used to identify the statistically significant factors including sex, age, schemes of transplantation, HLA-matched, mismathed, conditioning regimens, preventive measures for GVHD, occurrence of grade I-II GVHD, CMV infections and types of incompatible blood group. The results showed that minor ABO-incompatible, number of mononuclear cells infused, age of patients and unrelated BMT were four important main factors influening the erythrocyte recovery. In conclusion, the erythrocyte recovery is more quick in patients with minor ABO-incompatible and more number of mononuclear cells infused, while it is slow in patents with old age and unrelated BMT.
ABO Blood-Group System ; Adolescent ; Adult ; Blood Group Incompatibility ; blood ; complications ; Erythrocyte Count ; Erythrocytes ; cytology ; Female ; Graft vs Host Disease ; etiology ; prevention & control ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; statistics & numerical data ; Humans ; Leukemia ; therapy ; Male ; Middle Aged ; Proportional Hazards Models ; Regression Analysis ; Retrospective Studies ; Transplantation, Homologous