Blood group incompatibility in kidney transplantation: definitely time to re-examine!

We report a successful kidney transplant (A1 donor to an O recipient), with antibody removal pre- and post-transplant, and pre-transplant administration of anti-CD20 monoclonal antibody (rituximab), intravenous immunoglobulin, and conventional transplant immunosuppression. The transplant, which was performed without splenectomy, is the first such transplant in Australia. At 20 months, the patient's creatinine level was 110-130 micromol/L, with no evidence of rejection and no complications.

Recombinant activated factor VII: treating postoperative hemorrhage in cardiac surgery.

Background: The purpose of this study is to review the effect of recombinant activated factor VII (rFVIIa) as rescue therapy in continuing severe postoperative hemorrhage, despite conventional measures in a series of cardiac patients at our institution.

Methods: A series of all patients who received rFVIIa as rescue therapy for uncontrollable postoperative hemorrhage after cardiac surgery over a 2-year period was analyzed. We assessed and compared the use of blood products, coagulation indicators (international normalized ratio [INR], activated partial thromboplastin [APTT], and fibrinogen), and platelet levels immediately before and after the rFVIIa was given.

Use of red blood cell transfusions in surgery.

Background: Limited blood supplies necessitate the rational use of blood products. The aim of the present study was to provide a basis for audits of red cell usage in surgery by benchmarking common practice. Application of the data to the construction of a maximum surgical blood order schedule may be relevant for centres that perform a serological crossmatch or who collect autologous units.