[Hemolytic anemia and acute renal failure caused by blood transfusions]

We report a case of 33 years old woman who developed hemolytic anemia after blood transfusion. In this case no abnormalities were observed by the cross-match test performed before blood transfusion. She was undergone the surgical resection of liposarcoma of her right arm in June, 1984 and 8 units of the concentrated red blood cells were transfused during the operation. During the following 2 months 13 units of the concentrated red blood cells were transfused. Immediately after blood transfusion, she developed icterus and oliguria and was diagnosed acute renal failure associated with hemolytic anemia. At this time we examined the antigen type of her red blood cells and of three donors' red blood cells which had been given to her. As the result, either C (Rh-hr), Pi (P), Lea (Lewis), Fyb (Duffy) antigens were found in some of donors' RBC, but no such antigens were detected in her RBC. The half life span of RBC measured using 51Cr labeled RBC was 6.2-14.5 hours, in respect of the antigen-positive RBC, where as it was 49.4 hours in the RBC without the antigens. It is more likely that the blood transfusion was the cause of hemolytic episode in this case, because the half life span of the donors' RBC was extremely shortened, compared with that of her own blood which was 16 days.