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RhD 불일치 간이식 환자에서 동종면역 방지를 위한 고용량Rh 면역글로불린의 사용

Other Titles
 The Use of High-dose Rh Immunoglobulin for the Prevention of D Sensitization in RhDincompatible Liver Transplantation 
Authors
 박정래  ;  김신영  ;  최승준  ;  송성욱  ;  김현옥  ;  김순일 
Citation
 Laboratory Medicine Online, Vol.4(3) : 168-171, 2014 
Journal Title
 Laboratory Medicine Online 
ISSN
 2093-6338 
Issue Date
2014
Abstract
Approximately 80-85% of D-negative (D-) persons produce anti-D antibodies after exposure to D-positive (D+) red blood cells (RBCs). Previously, anti-D was the most commonly detected Rh antibody, but its incidence has greatly decreased due to the prophylactic use of Rh immunoglobulin (RhIG). Anti-D antibody formation may occur following RhD-incompatible organ transplantation when D- recipients are exposed to D+ RBCs that originate from a donor organ. As a large volume of donor blood may be contained within the transplanted organ, the use of a large amount of RhIG is required in RhD-incompatible liver transplantation. Here, we describe the use of a large amount of RhIG to treat a patient following RhD-incompatible liver transplantation. This patient was a 71-yr-old woman with hepatitis C virus-related liver cirrhosis, who had an A/D- blood type. The donor was her grandson, whose blood type was O/D+. The recipient's preoperative anti-D antibody test was negative. One unit of O/D- irradiated leukoreduced RBCs and three units of A/D- fresh frozen plasma were transfused during liver transplantation. An equal amount (12,000 IU) of RhIG was infused intravenously, immediately after liver transplantation and a second time on post-operation day 1. The anti-D titer was 1:64 on the first post-operation day, and had increased to 1:128 by the following day. By 1 month after the surgery, the titer had decreased to 1:4. In this case of liver transplantation, RhIG was actively used to prevent RhD sensitization and the subsequent occurrence of adverse events associated with RhD-incompatible liver transplantation.
Files in This Item:
T201403435.pdf Download
DOI
10.3343/lmo.2014.4.3.168
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
김순일(Kim, Soon Il) ORCID logo https://orcid.org/0000-0002-0783-7538
김신영(Kim, Sin Young) ORCID logo https://orcid.org/0000-0002-2609-8945
김현옥(Kim, Hyun Ok) ORCID logo https://orcid.org/0000-0002-4964-1963
최승준(Choi, Seung Jun) ORCID logo https://orcid.org/0000-0003-0736-1055
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99923
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