A case of effective transfusion of blood with a different ABO group that was otherwise compatible during emergency surgery for acute aortic dissection in a patient with blood group AB Rh-negative

Abstract

　We report the case of a 69-year-old woman with blood group AB Rh-negative who underwent emergency ascending aorta and partial arch replacement for acute type A aortic dissection. Since we could not obtain the necessary amount of ABO- and Rh-matched blood products during preoperative preparation for the surgery, we transfused 2000 ml of group A RhD-negative red blood cell concentrate and 250 ml of group AB RhD-positive platelet concentrate, which had been cross-match tested, during the surgery. Postoperatively, although transient mild worsening of biochemical parameters of hepatorenal function was observed, a clinically significant hemolytic reaction did not occur. Her subsequent hospital course was fairly uncomplicated, and she was discharged home on the 31st postoperative day. In the case of transfusion of otherwise compatible blood of a different ABO group to patients with blood group AB, group O blood cell concentrates tend to be selected. The current guidelines for critical bleeding in Japan recommend using group A or group B blood cell concentrates in such cases. In this case, the planned transfusion of ABO- and RhD- different but compatible blood products based on the guidelines was effective and safe for emergency cardiovascular surgery in a patient with the rare AB Rh-negative blood group.