Abstract
BackgroundAnti-Gerbich (Ge) alloantibody against high-frequency erythrocyte antigen is extremely rare. Owing to incomplete evidence regarding the degree and severity of adverse events induced by hemolytic transfusion reactions, the transfusion management often remains cumbersome in these patients. We report an anti-Ge alloantibody positive patient with hepatocellular carcinoma (HCC) who underwent central hepatectomy (CH) without the need for an allogeneic blood transfusion.Case presentationA 76-year-old Japanese woman was diagnosed with HCC measuring 9.5 × 8.0 cm in segments 4, 5, and 8 of the liver. This patient with anti-Ge alloantibody had a history of two pregnancies without transfusion. CH was planned, and based on the suggestion from the multidisciplinary team meeting, preoperative autologous donation (PAD) and acute normovolemic hemodilution (ANH) were performed. CH was successfully performed by using CUSA and Thunderbeat® with Pringle maneuver and infra-hepatic inferior vena cava clamping without perioperative need for an allogeneic blood transfusion. She has been alive without recurrence after a follow-up period of 45 months.ConclusionTo our knowledge, this is the first case report of hepatectomy in a patient with anti-Ge alloantibody. A multidisciplinary team approach, PAD and ANH, and bloodless liver surgical techniques appear to be useful for major hepatectomy in patients with extremely rare blood type.
Highlights
Anti-Gerbich (Ge) alloantibody against high-frequency erythrocyte antigen is extremely rare
We describe an anti-Ge alloantibody positive patient with hepatocellular carcinoma (HCC) who had a Komokata et al Surgical Case Reports (2020) 6:131 successful central hepatectomy without the need of an allogeneic blood transfusion
These included insertion of Swan-Gantz catheter for evaluation of cardiac function for moderate to severe aortic stenosis; insertion of a flexible double lumen catheter for continuous hemodiafiltration (CHDF) in preparation to deal acute hemolytic transfusion reactions (HTRs) preceded by an unanticipated transfusion; a collection of 700 ml autologous blood as acute normovolemic hemodilution (ANH); and a “stand-by” set up of intraoperative cell salvage
Summary
This is the first case report of hepatectomy in a patient with anti-Ge alloantibody.
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