Artificial Oxygen Carriers Save Lives in Expanded Access Use: Three Cases when Blood Was Not an Option.

Clinical Features: Sickle cell patients may develop a multitude of antibodies and experience life-threatening events with transfusion such as hyperhemolysis syndrome or delayed hemolytic transfusion reaction. Further transfusion may not be possible in such cases.

Therapeutic Challenge: When conventional blood products are not available for transfusion yet the patient requires additional oxygen-carrying support, artificial oxygen carriers may be required.

Hemolysis due to anti-IH in a patient with beta-thalassemia and infection.

Anti-IH is a common cold agglutinin that is typically clinically insignificant. We present a case that resulted in hemolysis. A 32-year-old male patient with transfusion-independent beta-thalassemia intermedia presented with symptomatic anemia.

Investigating anti-D in an individual with the weak D type 2 genotype.

Anti-D in individuals with a weak D phenotype is an unexpected finding that may require additional investigation to determine whether the anti-D is an autoantibody or alloantibody. Further investigation may also include assessment of the patient's genotype and exclusion of anti-G. We present a case of an 84-year-old man with the weak D type 2 genotype who developed an unexpected anti-D along with anti-C.

DAT-Negative Autoimmune Hemolytic Anemia.

Hematologists often rely on the results of a positive direct antiglobulin test to confirm a diagnosis of autoimmune hemolytic anemia, but immune hemolytic anemia can occur when no immunoglobulin is detectable by routine methods. Negative DATs in these patients may be due to a small quantity of IgG on their red blood cells (RBCs) (below detectable levels), or when low-affinity anti-IgG is present, or when the autoantibodies are IgA or IgM in nature. A panel of tests developed to detect immunoglobulins on these patients' RBCs may be performed in a few specialized laboratories.

Molecular basis of two novel and related high-prevalence antigens in the Kell blood group system, KUCI and KANT, and their serologic and spatial association with K11 and KETI.

Background: The numerous antigens in the Kell blood group system result from missense nucleotide changes in KEL. Antibodies to antigens in this system can be clinically important. We describe six probands whose plasma contained antibodies to high-prevalence Kell antigens and discuss their relationship.