Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie最新文献

{"title":"Plasma Transfusion Practice in Adult Surgical Patients: Systematic Review of the Literature.","authors":"Elisabeth Hannah Adam,&nbsp;Dania Fischer","doi":"10.1159/000511271","DOIUrl":"https://doi.org/10.1159/000511271","url":null,"abstract":"<p><strong>Background: </strong>Plasma transfusions are most commonly used therapeutically for bleeding or prophylactically in non-bleeding patients prior to invasive procedures or surgery. Although plasma transfusions generally seem to decline, plasma usage for indications that lack evidence of efficacy prevail.</p><p><strong>Summary: </strong>There is wide international, interinstitutional, and interindividual variance regarding the compliance with guidelines based on published references, supported by appropriate testing. There is furthermore a profound lack of evidence from randomized controlled trials comparing the effect of plasma transfusion with that of other therapeutic interventions for most indications, including massive bleeding. The expected benefit of a plasma transfusion needs to be balanced carefully against the associated risk of adverse events. In light of the heterogeneous nature of bleeding conditions and their rapid evolvement over time, fibrinogen and factor concentrate therapy, directed at specific phases of coagulation identified by alternative laboratory assays, may offer advantages over conventional blood product ratio-driven resuscitation. However, their outcome benefit has not been demonstrated in well-powered prospective trials. This systematic review will detail the current evidence base for plasma transfusion in adult surgical patients.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"347-359"},"PeriodicalIF":2.2,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000511271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38692748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Plasma Exchange in a Steroid- and IVIG-Refractory Patient with Acute Disseminated Encephalomyelitis: A Case Report.","authors":"Parmatma Prasad Tripathi,&nbsp;Rekha Hans,&nbsp;Ratti Ram Sharma,&nbsp;Divjot Singh Lamba,&nbsp;Preeti Paul,&nbsp;Naveen Sankhyan,&nbsp;Chandana Bhagwat,&nbsp;Paramjeet Singh","doi":"10.1159/000504987","DOIUrl":"https://doi.org/10.1159/000504987","url":null,"abstract":"<p><strong>Background: </strong>Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease usually affecting children and is treated with high-dose steroid therapy.</p><p><strong>Case report: </strong>An 8-year boy presented with limbs weakness and complete loss of vision and was resistant to steroid therapy. He was further treated with plasma exchange and showed full recovery from the neurological deficit.</p><p><strong>Conclusion: </strong>Therapeutic plasma exchange appears to be effective in ADEM patients in reversing the neuropathological process especially refractory to steroids and intravenous immunoglobulin.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"420-423"},"PeriodicalIF":2.2,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000504987","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38590935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Transfusion Practice in Children and Adolescents over Time.","authors":"Florian Piekarski,&nbsp;Andrea Steinbicker,&nbsp;Kai Zacharowski,&nbsp;Patrick Meybohm","doi":"10.1159/000511231","DOIUrl":"https://doi.org/10.1159/000511231","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, resource-saving handling of allogeneic blood products and a reduction of transfusion rates in adults has been observed. However, comparable published national data for transfusion practices in pediatric patients are currently not available. In this study, the transfusion rates for children and adolescents were analyzed based on data from the Federal Statistical Office of Germany during the past 2 decades.</p><p><strong>Methods: </strong>Data were queried via the database of the Federal Statistical Office (Destasis). The period covered was from 2005 to 2018, and those in the sample group were children and adolescents aged 0-17 years receiving inpatient care. Operation and procedure codes (OPS) for transfusions, procedures, or interventions with increased transfusion risk were queried and evaluated in detail.</p><p><strong>Results: </strong>In Germany, 0.9% of the children and adolescents treated in hospital received a transfusion in 2018. A reduction in transfusion rates from 1.02% (2005) to 0.9% (2018) was observed for the total collective of children and adolescents receiving inpatient care. Increases in transfusion rates were recorded for 1- to 4- (1.41-1.45%) and 5- to 10-year-olds (1.24-1.33%). Children under 1 year of age were most frequently transfused (in 2018, 40.2% of the children were cared for in hospital). Transfusion-associated procedures such as chemotherapy or machine ventilation and respiratory support for newborns and infants are on the rise.</p><p><strong>Conclusion: </strong>Transfusion rates are declining in children and adolescents, but the reasons for increases in transfusion rates in other groups are unclear. Prospective studies to evaluate transfusion rates and triggers in children are urgently needed.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"379-384"},"PeriodicalIF":2.2,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000511231","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38692751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Cohort Study to Assess the Effect of Storage Duration, Leuko-Filtration, and Gamma Irradiation on Cell-Free DNA in Red Cell Components.","authors":"Nitesh Gupta,&nbsp;Dheeraj Khetan,&nbsp;Rajendra Chaudhary,&nbsp;Jai Shankar Shukla","doi":"10.1159/000505937","DOIUrl":"https://doi.org/10.1159/000505937","url":null,"abstract":"<p><strong>Introduction: </strong>Damage to a cell and the loss of integrity of its cell membrane leads to the release of endogenous immunogenic molecules, which together are classified as \"damage-associated molecular patterns\" (DAMPs). Cell-free DNA (cf-DNA) released from nucleosomes may serve as a proco-agulant cofactor and may be an important mediator of immunomodulatory and proinflammatory effects associated with blood transfusion.</p><p><strong>Objectives: </strong>To assess the levels of cf-DNA in supernatants of stored red cell components and the effect of leukoreduction and gamma irradiation on the release of cf-DNA during storage.</p><p><strong>Methods: </strong>This is a prospective cohort study on 99 stored red cell components, randomly divided into three groups - buffy coat (BC)-depleted, leuko-filtered (LP), and irradiated (IR) packed red blood cells. Red cell supernatants were drawn over a period of 21 days at three different time points (day 0, 7, and 21) from the study units. cf-DNA extraction was done and quantified by a bench top fluorometer. Change in cf-DNA content, rate of change (μg/day), and percent change were estimated and compared across different groups.</p><p><strong>Results: </strong>cf-DNA content increased (<i>p</i> = 0.000) with storage duration in the BC (median = 238.66 μg, interquartile range [IQR] = 168.42 on day 21 vs. median = 9.44 μg, IQR = 5.23 on day 0) and IR groups (<i>p</i> = 0.000) (median = 245.55 μg, IQR = 253.88 on day 21 vs. median = 7.07 μg, IQR = 13.58 on day 0), while there was a decreasing trend (<i>p</i> = 0.032) in the LP group (median = 4.55 μg, IQR = 10.73 on day 21 vs. median = 8.66 μg, IQR = 6.56 on day 0). The median rate of change in cf-DNA content (11.13 μg/day) and percent change in cf-DNA content (median = 4,106.16%) was highest in the IR group.</p><p><strong>Conclusions: </strong>Stored red cell components contain significant amount of cf-DNA. Release of cf-DNA is further aggravated by irradiation while leukoreduction leads to a decrease in cf-DNA content.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"409-419"},"PeriodicalIF":2.2,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000505937","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38590934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Autophagic Activity on the Function of Apheresis Platelets and on the Efficacy of Clinical Platelet Transfusion.","authors":"Hao Tang,&nbsp;Meng Gao,&nbsp;Yunfeng Fu,&nbsp;Rong Gui,&nbsp;Xianjun Ma","doi":"10.1159/000504764","DOIUrl":"https://doi.org/10.1159/000504764","url":null,"abstract":"<p><p>Platelet activation and survival jointly determine the efficacy of clinical platelet transfusion. This study aimed to discuss the effect of autophagic activity on activation and aggregation of apheresis platelets and on the efficacy of clinical platelet transfusion. In this study, we investigated the effects of autophagic activity of apheresis platelets for different blood types and after different storage durations on platelet activation and aggregation functions. By Western blot, immunofluorescence, and RT-qPCR detection, we found that with the prolongation of the storage duration, the expressions of both autophagy-related proteins and genes were upregulated in apheresis platelets and their expressions were insignificantly higher in the apheresis platelets of type A and O blood than in those of type B and type AB blood. After RAPA/IGF-1 pretreatment, there was a significant increase/reduction in autophagic activity. After RAPA and IGF-1 pretreatment, an opposite variation trend was observed with platelet activation and aggregation. Autophagic activity of platelets correlated negatively with the efficacy of clinical platelet transfusion. These research findings provide a theoretical basis for effective clinical platelet transfusion.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"302-313"},"PeriodicalIF":2.2,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000504764","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel c.796 A>C Mutation in the <i>ABO</i>*<i>B.01</i> Allele Responsible for CisAB Phenotype.","authors":"Xiaofei Li,&nbsp;Huiwen Bi,&nbsp;Liping Sun,&nbsp;Faming Zhu,&nbsp;Deqing Wang","doi":"10.1159/000501107","DOIUrl":"https://doi.org/10.1159/000501107","url":null,"abstract":"<p><strong>Background: </strong>Individuals with the CisAB phenotype are rare in the Chinese population. In the present study, we investigated the sequence of the <i>ABO</i> gene and family members of a newborn suspected to have the CisAB phenotype.</p><p><strong>Methods: </strong>The ABO phenotype was detected using conventional serological tests. The full coding region of exons 1 to 7 of the <i>ABO</i> gene was amplified by polymerase chain reaction and was sequenced. The <i>ABO</i> haplotype was determined by the allele-specific primer sequencing method.</p><p><strong>Results: </strong>The proband and his father and grandfather were assigned the CisAB phenotype according to the results of the serological tests and family investigation. A novel <i>CisAB</i> allele was identified in the proband and his father and grandfather, which has only one nucleotide difference at position 796 from A to C (c.796A>C) compared with the <i>ABO</i>*<i>B.01</i> allele.</p><p><strong>Conclusion: </strong>A novel <i>CisAB</i> (c.796A>C mutation in <i>ABO</i>*<i>B.01</i>) allele is the first identified in the Chinese population.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"288-290"},"PeriodicalIF":2.2,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000501107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endogenous Heparin-Like Substances May Cause Coagulopathy in a Patient with Severe Postpartum Hemorrhage.","authors":"Shichun Wang,&nbsp;Chao Qi,&nbsp;Zhicheng Liu,&nbsp;Ting Xu,&nbsp;Chunyan Yao","doi":"10.1159/000504610","DOIUrl":"https://doi.org/10.1159/000504610","url":null,"abstract":"<p><strong>Introduction: </strong>Postpartum hemorrhage (PPH) is associated with maternal morbidity and mortality. Accurate diagnosis of the cause of puerperal hemorrhage is as important as treatment strategies for resuscitation. We report a case of coagulation disorder caused by endogenous heparin-like substances in a PPH patient.</p><p><strong>Case presentation: </strong>A 30-year-old woman with no medical history of bleeding disorders suffered intractable hemorrhage following spontaneous delivery in a local hospital. The patient was transferred to the department of obstetrics of a superior hospital. On arrival, the patient was found to have severe hemorrhagic anemia, hemorrhagic shock, and disseminated intravascular coagulation. Active treatments were performed, but the patient continued bleeding. Laboratory testing, performed during early treatment, revealed that all coagulation factors were below normal. The differences between CK-TEG R-time (reaction time in citrated kaolin thromboelastography assay) and CKH-TEG R-time (reaction time in citrated kaolin with heparinase thromboelastography assay) suggested the presence of heparin activity. However, the patient's family denied heparin use prior to presentation. Thus, we deduced that endogenous heparin-like substances were the main cause of the coagulopathy. After receiving treatment with protamine, the patient stopped bleeding. Meanwhile, all coagulation parameters and the TEG assay results improved.</p><p><strong>Conclusions: </strong>In this case report, TEG assay suggested the presence of heparin activity in a PPH patient, and treatment also highlighted the importance of analyzing different parameters in TEG.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"337-343"},"PeriodicalIF":2.2,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000504610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the in vitro Function of Platelet Concentrates from Pooled Buffy Coats or Apheresis.","authors":"Sarah Anna Fiedler,&nbsp;Klaus Boller,&nbsp;Ann-Christine Junker,&nbsp;Christel Kamp,&nbsp;Anneliese Hilger,&nbsp;Wolfgang Schwarz,&nbsp;Rainer Seitz,&nbsp;Ursula Salge-Bartels","doi":"10.1159/000504917","DOIUrl":"https://doi.org/10.1159/000504917","url":null,"abstract":"<p><strong>Background: </strong>Platelet concentrates play an important role in transfusion medicine. Their short lifespan and lack of robustness require efforts to ensure adequate product quality. In this study, we compared the in vitro quality of the main concentrate types, pooled platelet concentrate (PPC) from whole blood donations, and platelet concentrate from single-donor apheresis (APC).</p><p><strong>Methods: </strong>Twenty PPCs and 20 APCs prepared in plasma were analyzed on days 2, 4, and 7 of storage. Variables related to metabolism, degranulation, platelet aggregation, P-selectin expression, and annexin V binding were analyzed. Morphology was assessed by transmission electron microscopy of ultrathin sections. A microfluidic device was applied to test the effects of shear stress on platelet function.</p><p><strong>Results: </strong>The metabolic parameters indicated stable storage conditions throughout the 7-day period. The resting discoid form was the prevailing morphology on days 2 and 4 in the PPCs and APCs. Chemokine release and receptor shedding of soluble P-selectin and soluble CD40L equally increased in PPCs and APCs. Aggregation responses to ADP and collagen were heterogeneous, with marked losses in collagen responsiveness on day 4 in individual concentrates. Baseline expression of P-selectin in PPCs and APCs was low, and inducibility of P-selectin was well preserved until day 4. Under shear stress, equal adhesiveness and stability were found with platelets from PPCs and APCs.</p><p><strong>Conclusions: </strong>Platelets from PPCs and APCs showed similar in vitro function and stability parameters. However, platelet concentrates presented a high variability and individual concentrates an impaired functional capability. Identifying the factors contributing to this would help increase product reliability.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"314-324"},"PeriodicalIF":2.2,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000504917","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostaglandin E2 Reverses the Effects of DNA Methyltransferase Inhibitor and TGFB1 on the Conversion of Naive T Cells to iTregs.","authors":"Mehmet Sahin,&nbsp;Emel Sahin","doi":"10.1159/000502582","DOIUrl":"https://doi.org/10.1159/000502582","url":null,"abstract":"<p><p>Naturally occurring regulatory T cells (nTregs) are produced under thymic (tTregs) or peripherally induced (pTregs) conditions in vivo. On the other hand, Tregs generated from naive T cells in vitro under some circumstances, such as treatment with transforming growth factor-β (TGFB), are called induced Tregs (iTregs). Tregs are especially characterized by FOXP3 expression, which is mainly controlled by DNA methylation. nTregs play important roles in the suppression of immune response and self-tolerance. The prostaglandin E2 (PGE2) pathway was reported to contribute to regulatory functions of tumor-infiltrating nTregs. In this study, we examined whether PGE2 contributes to the formation of iTregs treated with TGFB1 and 5-aza-2'-deoxycytidine (5-aza-dC), which is a DNA methyltransferase inhibitor. We found that the protein and gene expression levels of FOXP3 and IL-10 were increased in 5-aza-dC and TGFB1-treated T cells in vitro. However, the addition of PGE2 to these cells reversed these increments significantly. In CFSE-based cell suppression assays, we demonstrated that PGE2 decreased the suppressive functions of 5-aza-dC and TGFB1-treated T cells.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"244-253"},"PeriodicalIF":2.2,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000502582","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38098624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Outcome of Hemolytic Disease of the Fetus and Newborn Caused by Anti-Rh17 Antibody: Analysis of Three Cases and Review of the Literature.","authors":"Slavica Dajak,&nbsp;Nina Ipavec,&nbsp;Mia Cuk,&nbsp;Branka Golubic Cepulic,&nbsp;Jela Mratinovic-Mikulandra,&nbsp;Josipa Milardovic,&nbsp;Vedran Stefanovic","doi":"10.1159/000503012","DOIUrl":"https://doi.org/10.1159/000503012","url":null,"abstract":"<p><strong>Background: </strong>Anti-Rh17 is a rare red blood cell (RBC) antibody to high-frequency antigens that may cause severe hemolytic disease of the fetus and newborn (HDFN). Despite the rarity of HDFN caused by Anti-Rh17, this antibody was reported in many different populations. Emergency transfusions, especially exchange transfusions, present a huge problem if no compatible RBCs of phenotype D- are available.</p><p><strong>Methods: </strong>Here we report obstetrical histories of three women and describe their pregnancies complicated by anti-Rh17 antibodies. We summarized published cases of pregnancies complicated by anti-Rh17 and reviewed transfusion treatment and outcomes. Additionally, a simplified flowchart for the management of such pregnancies is proposed.</p><p><strong>Results: </strong>Four pregnancies were affected by severe HDFN, and three of them ended with perinatal death. In the fourth case, the baby was born hydropic and icteric and the condition was rapidly deteriorating. Emergency exchange transfusion was performed with incompatible O-negative RBC units in AB-negative plasma. The baby was discharged on the 14th day in good health. In the available literature, 15 women and 22 pregnancies were reported, 20 of them developed severe HDFN. According to the data, intrauterine transfusion for treatment of HDFN was the most common form of treatment with the donation of the mother's blood. Different options for exchange transfusion were described, including incompatible RBCs.</p><p><strong>Conclusion: </strong>In more than 90% of described pregnancies of HDFN caused by anti-Rh17 antibody, transfusion treatment was required. Therefore, RBC from D- phenotype has to be available. According to published data, in emergent circumstances when maternal and blood from donor with phenotype D- is not available, incompatible exchange transfusion is a better choice than delaying transfusion when it is necessary. It is of essential importance that pregnancies with high risk of HDFN due to anti-Rh17 are managed by a multidisciplinary team (transfusion medicine specialist, obstetrician, neonatologist) in a highly specialized tertiary institution.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"264-271"},"PeriodicalIF":2.2,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000503012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38098625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}