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PEDIATRIC ANESTHESIOLOGY

ABO-Incompatible Blood Transfusion and Invasive Therapeutic Approaches During Pediatric Cardiopulmonary Bypass

Yasin Aliç, MD^*, Elif A. Akpek, MD^*, Asl Dönmez, MD^*, Süleyman Özkan, MD, Güray Yener Perfusionist, and Sait Alamaci, MD

From the Departments of *Anesthesiology, and Cardiovascular Surgery, Bakent University Faculty of Medicine, Ankara, Turkey.

Address correspondence and reprint requests to Elif A. Akpek, MD, Department of Anesthesiology, Bakent University Faculty of Medicine, 10.sok, No 45 Bahçelievler, 06490–Ankara, Turkey. Address e-mail to elifakpek{at}baskent-ank.edu.tr.

Abstract

Human error has been identified as a major source of ABO-incompatible blood transfusion which most often results from blood being given to the wrong patient. We present a case of inadvertent administration of ABO-incompatible blood to a 6-mo-old child who underwent congenital heart surgery and discuss the use of invasive therapeutic approaches. Invasive techniques included total circulatory arrest and large-volume exchange transfusion, along with conventional ultrafiltration and plasmapheresis, which could all be performed rapidly and effectively. The combination of standard pharmacologic therapies and alternative invasive techniques after a massive ABO-incompatible blood transfusion led to a favorable outcome in our patient.