A Case of Sickle Cell Anemia with a Lack of High Frequency Red Blood Cell Antigen / 대한수혈학회지

Patients with sickle cell anemia are chronically transfused. Therefore, it is important to prevent the alloimmunization of RBC antigens. The authors identified a high frequency antigen-negative blood group in patients with sickle cell anemia. As the number of foreigners residing in Korea is increasing, it is necessary to know what to consider when transfusing blood to sickle cell anemia patients. Patients with sickle cell anemia should be informed of the exact blood group type using extended RBC typing to confirm the ABO, Rh, Kell, and Duffy blood types at diagnosis or before the first blood transfusion. Extended matched blood transfusion can reduce the risk of alloimmunization of RBC antigens.

Transfusion of Jra-positive Red Blood Cells to a Jra-negative Patient with Anti-Jra / 대한수혈학회지

Jra is a high-frequency red cell antigen, and antibodies to Jra (anti-Jra) are rarely found. The clinical significance of anti-Jra has been under debate. We report a case of a Jra negative patient having anti-Jra who was urgently transfused with Jra-positive red blood cells (RBCs) during an aortic valvuloplasty. As Jra-negative RBCs were not available, this 57 year-old female patient was transfused with six units of Jra-positive RBCs during the surgery. The hemoglobin concentration decreased from 13.0 g/dL to 7.7 g/dL due to excessive bleeding, but increased up to 13.2 g/dL after the transfusion of an additional four units of Jra-positive RBCs. A direct antiglobulin test (DAT) was positive on day 3 and day 10 after surgery. Twenty days following surgery at the outpatient clinic, the hemoglobin concentration was 10.4 g/dL and the patient had no clinical symptoms related to anemia. The DAT was negative 6 months after the transfusion. It seems to be relatively safe to transfuse Jra-positive RBCs to the patient with anti-Jra in an emergency situation.