Incompatible blood transfusions in liver transplant patients with significant red cell alloantibodies.

L IVER TRANSPLANT patients often need large amounts of blood. I The presence of significant red blood cell (RBC) alloantibodies in these patients complicates the blood bank's ability to provide the necessary blood products. In the first 1000 liver transplantations performed at our center, 13.7% of adults and 6.3% of children had significant RBC alloantibodies.2 We now have had 17 patients with significant RBC antibodies, rapid surgical blood need, and use of potentially incompatible blood untested for offending antigens. (Eight cases were noted previously.2) In this report we analyze our growing experience, characterize the cases according to outcome, and discuss our blood bank's approach to this problem.