ABO-incompatible living-donor pediatric kidney transplantation in Japan

The Japanese ABO-Incompatible Transplantation Committee officially collected and analyzed data on pediatric ABO-incompatible living-donor kidney transplantation in July 2012. The age of a child was defined as <16 years, and 89 children who had undergone ABO-incompatible living-donor kidney transplantation from 1989 to 2011 were entered in a registry. These data were presented as the Japanese registry of pediatric ABO-incompatible living-donor kidney transplantation at the regional meetings of the International Pediatric Transplantation Association (IPTA) in Nagoya in September 2012 and in Sao Paulo in November 2012.

Mismatched transfusion of 8 ABO-incompatible units of packed red blood cells in a patient with acute intermittent porphyria

We report on a patient with acute intermittent porphyria, who received 8 ABO incompatible units of packed red blood cells in an emergency situation. She never showed any signs of severe intravascular haemolysis. The patient died after four weeks because of a multi-organ failure caused from the malpractice of the porphyria. The problems of bedside testing, mixing field reaction, fresh frozen plasma and molecular-genetic determination of bloodgroup were discussed

Sistema ABO e infertilidade / Infertility and blood group ABO system

OBJETIVOS: A incompatibilidade ABO está associada com algumas patologia e estudos sugerem também uma possível associação com a infertilidade. O objetivo deste estudo foi verificar se a incompatibilidade ABO entre os casais pode ser um fator contribuinte para o quadro de infertilidade. MATERIAL E MÉTODOS: Foram analisados 161 casais quanto ao grupo sangüíneo ABO e divididos em dois grupos: Grupo 1 - constituído por 72 casais férteis e grupo 2 - constituído por 89 casais inférteis. Análise estatística foi realizada pelos testes Fischers exact test e chi-square test p menor que 0,05. RESULTADOS: Os resultados mostraram um aumento significativo na incompatibilidade ABO nos casais inférteis 38(42,7%) quando comparado com a dos casais férteis 15(25%). Observamos também uma maior freqüência do grupo sangüíneo O nos homens férteis e do grupo B nos homens inférteis. CONCLUSÕES: Os resultados sugerem que a incompatibilidade ABO pode ser um fator contribuinte para a infertilidade, evidenciado pelo aumento significativo da incidência de casais ABO incompatíveis no grupo de casais inférteis

Fetomaternal alloimmune thrombocytopenia presenting as intracerebral bleeding in utero.

Feto-maternal alloimmune thrombocytopenia is a serious fetal disorder resulting from platelet antigen incompatibility between the mother and the fetus. Intracranial bleeding is the most serious complication of alloimmune thrombocytopenia and can result in severe disability and death in utero. The authors report a case of intracerebral hemorrhage in utero resulting from alloimmune thrombocytopenia.

A Case of Hemolysis in ABO-unmatched Liver Transplantation: Use of Washed Group O Red Blood Cells and Steroids / 대한소화기학회지

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.

A new look on neonatal jaundice.

Out of 6586 live born babies, 736 babies with jaundice were studied from 1st July 1996 to 30th June, 1997, in a city based medical college nursery. Physiological jaundice was present in 8.92% of all live born babies and accounted for 79.89% of babies with jaundice. Breast milk jaundice and prematurity were next common causes responsible for 5.29% each of all cases with neonatal jaundice. Septicaemia caused jaundice in 4.75% cases. Among the babies with jaundice appearing between day 4 and day 7 of life, breast milk jaundice was the commonest cause occurring in 49.25% cases. The last entity surfaced probably due to exclusive breastfeeding recently initiated in the baby friendly hospital nursery.

Haemolytic anaemia after ABO-mismatched living-donor kidney transplantation

ABO.mismatched transplants are used frequently. Acquired haemolytic anaemia have been reported after ABO mismatched transplantation. Among 214 ABO.unmatched living-donor kidney transplants tS, 10 cases with cyclosporine based therapy developed haemolysis All studied patients had pre-transplant non specific blood transfusion and received kidneys from one haplotype HLA mismatched living donors. There were 164 males and 50 females. while the mean age was 30.41 years. CsA was stopped in patients treated with triple Immunosuppression while the patients received Pred-CsA were switched to conventional immunosuppression 6 patients were transfused with washed O cells and no plasma exchange was required. The prognosis was excellent in 9 patient, and one died from severe haemolysis. The haemolytic anaemia was more frequent among blood group A recipients [60% of our cases] and more severe among recipients with blood group B. Univariate analysis demonstrated significant impact for recipient age. donor sex, number of pretransplant blood transfusions. primary immunosuppression, time to onset of diuresis, recipient and donor blood groups. On the other hand, multivariate analysis restricted the significance to blood group of donor and recipient. time to onset of diuresis and primary immunosuppression. ABO unmatched kindray transplantation had no impact on patient survival, mean while the graft survival appeared to be better among unmatched ABO group in comparison to the same blood group recipients

The benefit of the direct antiglobulin test using gel technique in ABO hemolytic disease of the newborn.

The direct antiglobulin test (DAT) using the gel technique was included in the investigation of infants with hyperbilirubinemia in the first week of life. Twelve cases were preterm and 48 cases were full term infants. The patients were divided into 2 groups: the study group comprised 22 cases of blood group A or B infants born to blood group O mothers; the control group comprised 38 cases of ABO blood groups compatible with those of their mothers. The mean +/- SD (39 +/- 26 hours) of the age at the onset of hyperbilirubinemia induced by ABO hemolytic disease of the newborn (HDN) was significantly earlier than that due to other causes. The positive rate of DAT in the ABO incompatible group was similar by both the conventional technique and the gel technique, 54.5% and 50% respectively. However, the scores by the gel technique were higher than those of the conventional technique. The gel technique is simple, reliable, involves less technical error and requires a small amount of blood sample. The grading system is clear-cut, especially grade 1 + or weak positive as compared to the conventional technique which requires examination under a microscope. Therefore, the DAT using the gel technique is beneficial to the diagnosis of ABO HDN. It should be included in the investigation of infants with hyperbilirubinemia especially in case of suspected ABO HDN.

Neonatal jaundice due to ABO incompatibility in Sri Lankan.

A prospective study was carried out on 101 neonates with jaundice due to ABO incompatibility. The direct Coomb's test was weakly positive in 4 cases. The indirect Coomb's test using the eluate was positive in 8 cases. In the maternal blood either IgG anti-A or anti-B haemolysin was present in high titre in every case. Phototherapy was given when the indirect serum bilirubin level exceeded 9 mg/dl. Exchange transfusion was done-in 39 cases, 9 babies requiring multiple exchanges. There were 2 deaths.