Abstract:
BACKGROUND:Transfusion of D+ red blood cells (RBCs) to D- recipients can be accidental or necessary due to D- RBC shortage. Alloimmunization can complicate future transfusions; implications for women of childbearing age are compounded by possible hemolytic disease of the fetus and newborn. Rh immunoprophylaxis is effective, and indicated, for preventing alloimmunization. Reports of massive D+ mismatch (e.g., in the case of fetal-maternal bleed) are limited, and standard recommendations for managing these rare events are lacking. The cases discussed herein of women of childbearing age who suffered severe trauma requiring emergency surgery illustrate the dilemma of determining the ideal strategy for Rh immunoprophylaxis. CASE REPORTS:The first patient received two units of mismatched RBCs and was treated with intravenous Rh immune globulin (IV RHIG; Rhophylac, CSL Behring, Kankakee, IL) monotherapy beginning 49 h postsurgery. For the second patient, who received three units of D+ RBCs, partial RBC exchange transfusion, followed 48 h later by IV RHIG, was deemed appropriate based on the large volume of RHIG needed and concerns of hemolytic transfusion reaction and hyperbilirubinemia. Both patients recovered in full without further intervention; the first patient delivered a healthy child approximately 11 months posttreatment. CONCLUSIONS:Rh immunoprophylaxis is effective, and indicated, for preventing alloimmunization in women of childbearing age to protect the mother, fetus, and newborn. For the general population, a case-by-case approach is recommended. The availability of IV RHIG improves patient safety by facilitating the delivery of such treatment. RBC exchange should be considered for large volume mismatches.
journal_name
J Clin Apherjournal_title
Journal of clinical apheresisauthors
Werch JBdoi
10.1002/jca.20225subject
Has Abstractpub_date
2010-01-01 00:00:00pages
70-3issue
2eissn
0733-2459issn
1098-1101journal_volume
25pub_type
杂志文章abstract::The combined use of immunoadsorption (IA) and membrane filtration (MF) may markedly enhance removal of IgM and complement component C1q, supporting its use as an element of recipient desensitization in antibody-incompatible transplantation. However, coagulation factor removal may contribute to altered hemostasis, posi...
journal_title:Journal of clinical apheresis
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/jca.21399
更新日期:2016-02-01 00:00:00
abstract::Since the introduction of hematopoietic growth factors, the collection of mobilized stem cells via leukapheresis has widely replaced the harvest of bone marrow in both autologous and allogeneic transplantation settings. We investigated the frequency and the extent of anticoagulant-induced electrolyte changes and the c...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/1098-1101(2000)15:4<230::aid-jca3>3.0.co;2
更新日期:2000-01-01 00:00:00
abstract::Although rituximab (RTX) is a promising therapeutic agent for treating steroid-resistant nephrotic syndrome (SRNS) resistant to various immunosuppressive agents, some patients have shown resistance to RTX. We report the case of a patient with RTX-resistant nephrotic syndrome and SRNS who was successfully treated with ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21613
更新日期:2018-06-01 00:00:00
abstract::Sickle cell disease (SCD) patients are prone to develop complications that include stroke, acute chest syndrome, and other crises. Some of these complications require chronic transfusion therapy or red cell exchange (RCE), either for therapeutic or prophylactic reasons. Due to a discrepancy of red cell antigens betwee...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.20112
更新日期:2006-12-01 00:00:00
abstract::An improved method for intermittent-flow erythrocytapheresis in patients with sickle cell disease is reported. The method, a modification of the standard red cell exchange procedure for the Haemonetics 30S unit, dilutes with physiologic saline the patient's blood as it flows from the draw line and before it reaches th...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920030203
更新日期:1986-01-01 00:00:00
abstract::Because the administration of hematopoietic growth factors and the use of stem cell support often fails to alleviate the neutropenic phase induced by cytotoxic drugs, several investigators have attempted to expand ex vivo hematopoietic progenitors for clinical use. These attempts have clearly shown that the cultured c...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10012
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Autologous stem cell transplantation (auto-SCT) is a treatment approach in non-Hodgkin lymphoma (NHL) patients. The options for mobilization of CD34+ cells to support high-dose therapy are granulocyte-colony stimulating factors (G-CSFs) alone or after chemotherapy. Limited data exist on the efficacy of lipeg...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21785
更新日期:2020-08-01 00:00:00
abstract::Plerixafor in combination with granulocyte-colony stimulating factor (G-CSF) is approved for autologous stem cell mobilization in poor mobilizing patients with multiple myeloma or malignant lymphoma. The purpose of this study was to evaluate efficacy and safety of plerixafor in an immediate rescue approach, administra...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21496
更新日期:2017-08-01 00:00:00
abstract::Mobilized PBSC are the main source for allogeneic HSCT. We aimed to evaluate factors that affect CD34+ cell yield including the donor's age, gender, BSA, processed blood volume and the method of G-CSF dose calculation. Data from 170 healthy donors were analyzed. The concentration of CD34+ cells in the peripheral blood...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21524
更新日期:2017-12-01 00:00:00
abstract::Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease treated successfully with plasma exchange. Jehovah's Witnesses whose religious beliefs preclude them from accepting plasma exchange may require alternative forms of therapy. We report a case of one such patient who presented with TTP, whom we succ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20150
更新日期:2007-01-01 00:00:00
abstract::The infusion of high-dose (275 mg/kg body weight) immune globulin intravenous (IGIV) after 466 plasma exchanges in 64 patients with autoimmune disease was studied. Side effects occurred during 15% of IGIV infusions. For the most part they were transient and mild, and could be controlled by slowing the infusion rate. T...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920010207
更新日期:1983-01-01 00:00:00
abstract:INTRODUCTION:Limited data are available describing indications for and outcomes of therapeutic plasma exchange (TPE) in cardiac transplantation. METHODS:In a retrospective study of patients who underwent cardiac transplantation at Duke University Medical Center from 2010 to 2014, we reviewed 3 TPE treatment patterns: ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21622
更新日期:2018-08-01 00:00:00
abstract::The process of publishing original work in a peer review journal is not complete at the point where the manuscript is first submitted. The journal editors will submit the manuscript to peer review whereby outside experts are asked to vet the manuscript for scientific merit, originality and quality. Reviewers' comments...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.21822
更新日期:2020-08-07 00:00:00
abstract:OBJECTIVE:Effects of therapeutic plasma exchange (TPE) on immune cells and their cytokine production in MS, are unknown. Since interleukine-6 and tumor growth factor-β have critical roles in MS immunopathogenesis, the impacts of TPE on the expression of these cytokines and their receptors on the surface of CD4+ T lymph...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21755
更新日期:2020-04-01 00:00:00
abstract::The removal of specific antibody in experimental animals has been reported to result in a subsequent increase in antibody to levels equal to (rebound) or exceeding those existing prior to removal (overshoot). Anecdotal reports suggest that rebound antibody synthesis after plasmapheresis may occur in humans with autoim...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920050304
更新日期:1990-01-01 00:00:00
abstract::The issues of providing quality blood products and maintaining donor safety are primary aims of blood transfusion services. A comprehensive quality system should be in place to fulfill these aims, which can be attained through strict adherence to the established standard operating procedures (SOPs). The Drugs and Cosm...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20056
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Currently, low titer A plasma is used on a routine basis in bleeding trauma patients of unknown AB type. Three AB non-bleeding apheresis patients are presented here who safely received a combination of AB and low titer A plasma during therapeutic plasma exchange (TPE). One control AB patient received AB plas...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21656
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:ABO- or HLA-incompatible kidney transplantation is possible thanks to pretransplant antibody-depletion achieved by extracorporeal-treatment modalities. These methods induce depletion of some plasma proteins and may also impact on proteins involved in hemostasis. METHODS:To determine the impact of one sess...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21825
更新日期:2020-08-17 00:00:00
abstract::This study examined the incidence and predictors of peripheral blood stem cell (PBSC) mobilization failure in patients with multiple myeloma (MM). Retrospective data for 104 patients who received granulocyte colony-stimulating factor (G-CSF) alone or with cyclophosphamide as mobilization regimens were analyzed. The ra...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21326
更新日期:2014-12-01 00:00:00
abstract::Transfusion-acquired babesiosis can be an asymptomatic or self-limited febrile hemolytic illness in a healthy host. A persistent, relapsing, and/or fulminant course with the development of life-threatening complications may be seen in immunocompromised or splenectomized patients. As in malaria, erythrocyte parasitemia...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20262
更新日期:2010-01-01 00:00:00
abstract::Bone marrow (BM) damage after previous chemotherapy, such as that involving alkylating agents, and radiation therapy alone cannot explain poor hematopoietic progenitor cell mobilization. We examined the T lymphocytes of BM in 67 autologous peripheral blood stem cell transplant (auto-PBSCT) patients with non-Hodgkin ly...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21817
更新日期:2020-07-28 00:00:00
abstract::Peripheral blood stem cells (PBSC) reinfusion appears to hasten hematologic reconstitution following myeloablative therapy. While procurement of PBSC adds apheresis procedures, rapid engraftment could decrease the demand for platelet transfusions. To determine the impact of PBSC collection on workload in our apheresis...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920070408
更新日期:1992-01-01 00:00:00
abstract::Staphylococcal protein A efficiently binds immunoglobulins and circulating immune complexes (CIC) and provides an effective medium to remove immunoglobulins and CICs from plasma while sparing albumin and most coagulation proteins. Although it activates the complement system its clinical use abrogates the need for plas...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.2920090109
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Specialized centers claim a need for blood component production independent from the general blood transfusion services. We performed a prospective change control analysis of the transfer of platelet (PLT) production for hematological patients at the University Hospital Basel from the Departme...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21214
更新日期:2012-01-01 00:00:00
abstract::The literature on the use of therapeutic apheresis is often criticized for the preponderance of low to very low quality evidence. Shehata et al. examined the apheresis literature published between 1976 and 1999 and found a lack of randomized controlled trials with those identified demonstrating significant limitations...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.21263
更新日期:2013-02-01 00:00:00
abstract::Extra-corporeal photopheresis (ECP) is known as safe ultimate treatment option for chronic lung allograft dysfunction (CLAD). Here, we report the first case of ECP as "second-line" immunomodulatory therapy early post-transplant in an adult patient undergoing lung transplantation for severe chronic thromboembolic pulmo...
journal_title:Journal of clinical apheresis
pub_type:
doi:10.1002/jca.21831
更新日期:2020-08-24 00:00:00
abstract::Prestorage leukocyte reduction of platelet concentrates may reduce adverse effects of transfusion while affording better quality control. Platelets and leukocytes may undergo activation during storage, which could affect the performance of leukocyte reduction filters. The purpose of this study was to evaluate the effi...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/(sici)1098-1101(1997)12:1<14::aid-jca4>3.0
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Plasma exchange (PE) and double filtration plasmapheresis (DFPP) are known as effective treatment options for hyperviscosity syndrome (HVS) caused by Waldenstrom macroglobulinemia. Nonetheless, few data are available for the relation between the prescribed dose of apheresis and the reduction rate of target m...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21655
更新日期:2018-10-01 00:00:00
abstract::We describe the case of a 24 year old male with severe fistulating Crohn's disease who failed mutliple modalities of medical and surgical therapy. We present objective and subjective evidence of disease remission after induction and maintenance treatment with leukocyte apheresis. This is the first described case of su...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21308
更新日期:2014-06-01 00:00:00
abstract::We sought to optimize direct intravenous infusion of calcium gluconate (CaGlu) for maintaining plasma ionized calcium concentration ([Ca2+ ]) and preventing hypocalcemic reactions during 34 consecutive 1-volume therapeutic plasma exchanges (TPEs) in eight patients. CaGlu, 2 g in 50 mL of 0.9% NaCl, was prepared by our...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21742
更新日期:2019-12-01 00:00:00