@article{oai:nagoya.repo.nii.ac.jp:00024938,
 author = {Kurata, Nobuhiko and Onishi, Yasuharu and Kamei, Hideya and Hori, Tomohide and Komagome, Masahiko and Kato, Chiaki and Matsushita, Tadashi and Ogura, Yasuhiro},
 issue = {7},
 journal = {Transplantation Proceedings},
 month = {Sep},
 note = {A 48-year-old Japanese woman was diagnosed with Budd-Chiari syndrome and transferred
for possible living donor liver transplantation (LDLT). Examinations before LDLT
revealed that the recipient had anti-Jrª and preformed donor-specific antiehuman leukocyte
antigen (HLA) antibodies (DSA). Rituximab was administrated at 16 days prior to the
patient’s scheduled LDLT for the prophylaxis of antibody-mediated rejection by DSA. The
clinical significance of anti-Jrª has not been clearly established because of the rarity of this
antibody, so we discussed blood transfusion strategy with the Department of Blood
Transfusion Service and prepared for Jrª
-negative packed red blood cells (RBCs). Intraoperative
blood salvage was used during LDLT procedures to reduce the use of packed
RBCs. Although post-transplantation graft function was excellent, a total of 44 U of
Jrª
-negative RBCs were transfused during the entire perioperative period. Because suffi-
cient amounts of Jrª
-negative packed RBCs were supplied,  Jrª　mismatched blood transfusion
was avoided. The patient was discharged from our hospital on postoperative
day 102 without clinical evidence of any blood transfusionerelated adverse events.
Although there are some controversies of blood transfusion related to anti- Jrª　antibodies,
the current strategies of blood transfusion for liver transplantation with anti-Jrª are as
follows: (1) sufficient supply and transfusion of Jrª
-negative matched packed RBCs and
(2) application of intraoperative blood salvage to reduce the total amount of rare blood
type RBCs. These strategies may be changed when the mechanism of anti-Jrª alloimmunization
is fully understood in the future.},
 pages = {1604--1607},
 title = {Successful Blood Transfusion Management of a Living Donor Liver Transplant Recipient in the Presence of Anti-Jrª: A Case Report},
 volume = {49},
 year = {2017}
}