항-Fya 항체를 가진 환자에게 정주면역글로불린 및 스테로이드 투여와 함께 최소부적합 혈액 수혈

Abstract

Antibody to high-incidence antigens is one of the most challenging issues in transfusion medicine. Transfusion of the least-incompatible red blood cell (RBC) unit is standard practice, which may sometimes result in unfavorable outcomes. In this case, we attempted to transfuse the least-incompatible blood with intravenous immunoglobulin (IVIG) and steroid to a patient with anti-Fya. A 39-year-old female patient with liver cirrhosis was admitted for nausea and vomiting. Her hemoglobin level was 5.5 g/dL. Antibody identification tests showed anti-E, c, Jkb, and Fya alloantibodies. As Fya is a high-incidence antigen in Korea, she was transfused with 8 least-incompatible RBC units containing the Fya antigen in conjunction with IVIG and methylprednisolone. Although evidence of mild hemolysis was found in laboratory tests, there were no significant side effects. To the best of our knowledge, this is the first report of a transfusion strategy for a patient with anti-Fya.