Dharmesh Chandra Sharma, Sunita Rai, Sudha Iyengar, Bharat Jain, Satya Sao, Ajay Gaur, Rahul Sapra Efficacy of Whole Blood Reconstituted (WBR) in Exchange Transfusion (ET) in Hemolytic Sisease of New Born (HDN) – A study of 110 Cases.Open Journal of Blood Diseases, 2013; 3(1): 15-20. DOI: 10.4236/ojbd.2013.31004,
Hi, it is common practice to use group O red cells for exchange transfusion in HDN, although it must be antigen negative for the causative antibody specificity.
There are 2 reasons for using group O.
1. the national blood service will identify suitable phenotyped units to make into exchange units
2. it eliminates any complications which may be caused by maternal IgG anti-A and or Anti-B.
At the moment in the UK, the units for exchange are partially packed but AB plasma is not used
Hallo Linda Hoyland,
When you are using semi packed O cell two possibilities are still there
1. You are transfusing IgM anti A and Anti B to the recipient which can cause intra vascular hemolysis of variable degree.
2. You are reducing the Albumin binding sites which are require for the removal of bilirubin from the circulation because due to high bilirubin albumin sites are already exhausted.
I think O+/- cell( mothers Rh status ) + AB plasma is a better option by this you can ensure the HCT of unit and its albumin constants
Yes that's true, but the IgM anti-A and anti-B is not a particular problem as the donor is selected to have low tire antibodies.
Secondly, by using O red cells with AB plasma, you are increasing donor exposure.
I have known the plasma to be replaced by human albumin solution which replaces the bilirubin binding capacity and removes the ABO incompatibiliy
To,
Linda Hoyland
Though there is risk of donor exposure, we are doing this practice in routine . one can add human albumin in plasma to increase the albumin sites. As we are doing the exchange transfusion, will Human albumin serve the purpose of plasma. Is human albumin is isotonic solution . My article on this subject is
Dharmesh Chandra Sharma, et al Efficacy of Whole Blood Reconstituted (WBR) in Exchange Transfusion (ET) in Hemolytic Sisease of New Born (HDN) – A study of 110 Cases.Open Journal of Blood Diseases, 2013; 3(1): 15-20. DOI: 10.4236/ojbd.2013.31004,