CLINICAL EXAMINATION OF ERYTHROCYTE HALF-LIFE AFTER EXCHANGE TRANSFUSION IN A NEWBORN WITH HEMOLYTIC DISEASE OF THE FETUS AND NEWBORN

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  • 交換輸血を要した抗D抗体による新生児溶血性疾患の臨床経過と輸血された赤血球半減期の検討

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RhoD (+) fetuses or newborns of women with anti-D frequently show serious hemolytic disease. We report herein a RhoD(+) newborn from a RhoD(-) woman who developed hemolytic disease of the fetus and newborn and describe the time course of the ratio between RhoD(-) and RhoD(+) erythrocytes after exchange transfusion (ET). Her fetus showed no serious complications without treatment, despite markedly increased titers of anti-D in plasma up to 1: 2,048 at birth. However, because total bilirubin and hemoglobin levels deteriorated immediately after birth, high-dose immunoglobulin administration, phototherapy, and ET were performed and proved successful. We administered a mixture of O-type RhoD(-) red cell concentrate and AB-type RhoD(+) flesh frozen plasma for ET. Flow cytometric analysis showed that most erythrocytes in the newborn were substituted for transfused O-type RhoD(-) red blood cells immediately after ET. The ratio of RhoD(+) erythrocytes then increased daily, in contrast to RhoD(-) erythrocytes, which disappeared by 86 days after ET. The half-life of transfused erythrocytes was approximately 36 days, suggesting that manipulated erythrocyte products show a half-life comparable to that of erythrocytes in healthy adults.<br>

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