[Transfusion management of a patient with multiple anti-erythrocyte antibodies (anti-c + anti-K + anti-Fyb + anti-Jkb) subjected to a valvular reoperation using extracorporeal circulation]. / Manejo transfusional de un paciente con múltiples anticuerpos antieritrocitarios (anti-c + anti-K + anti-Fyb + anti-Jkb) sometido a reintervención valvular bajo cirugía extracorpórea (CEC).

A woman with multiple anti-red cell antibodies (anti-c, anti-K, anti-Jkb, anti-Fyb) due to previous transfusions was admitted to the hospital for valvular replacement. To ensure enough transfusional supply, a high number of packed red cell units was typed and screened prior to previous operation. Haemorrhagic complications developing during surgery led to transfusion of 32 blood units, 20 of them compatible. Besides this, measures directed to prevent complications derived from haemolytic disease were instituted. These included intravenous fluids and diuretics to maintain circulatory integrity and improve renal cortical blood flow. High-dose gammaglobulin was also administered in an attempt to decrease extravascular haemolysis. Despite therapy, severe adult distress respiratory syndrome caused patient's death nine days after surgery. We remark the need of storing frozen blood of low-frequency phenotypes in blood banks to face significant transfusional problems, providing sufficient numbers of antibody-compatible blood.