Abstract
Plasmapheresis has recently evaluated as an alternative to intrauterine transfusion for the management of severe alloimmunized pregnancy. We have experienced five successful cases of severe rhesus alloimmunized pregnancy, by performing plasmaphereses. Two cases of which were successive pregnanices of the same woman in 1982 and 1983 We treated these two cases by performing plasmaphereses applying selective antibody adsorption using D (+) red blood cells. In our procedure, about 3 liters or 4 liters of maternal plasma was remored by an IBM 2997 blood cell separator. Then a mixture of one unit (In Japan, One unit is 200ml as fresh blood) of leucoute poor packed red cell sediment, and 350ml or 250ml of maternal plasma was incubated in an water 6ath of 37°C for 5 minutes. The incubation ratio of red cells and maternal plasma was 1:3 or 1:2. After centrcfugation and careful elimination of incubated red cells by Haemonetics Model The refined plasma was frozen for use as the replacement fluid in the next exchange. We perfomed 34 plasma phereses in her fourth pregnancy. The fact that we were able to perform frequent plasmapheresis safely for both the mother and infant underscores the efficacy of our procedure.
