A 25 yr old female patient with severe iron deficiency Anemia (Hb- 4.9 gm/dl) and general edema on the body was admitted in a local hospital. She had a history of 1 delivery (full term) and 1st trimester abortion in the recent past. She had also received multiple transfusion of RCC within last 10 days. Upon processing the requisition for issue of 2 RCC units, presence of irregular antibodies was detected on the Galileo antibody screening test. Sequential cross-matches (15 in number) through multiple modes (room temperature and pre-warm techniques) failed to find perfectly matching type for the patient even on Galileo machine due to presence of irregular antibody produced mainly because of recent history of transfusion.
With the expert intervention of Medical Director, finally 2 units with matching (cross-match with pre warm technique) compatibility were found.
The treating doctor was advised to carry out very slow transfusion under constant clinical monitoring. The clinician was further advised to keep the patient warm (by switching off A/C and covering the patient with warm blanket) during transfusion. The doctor was further requested to monitor post-transfusion Hb level and report back. The report of Hb was sent to blood bank after 3 days which showed the Hb level raised upto to 8.3 gm/dl.
This would not have been possible without the use of the advanced technique. Unknowingly only saline matched units would have been transfused causing further hemolysis in the patient.
