{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:39:33Z","timestamp":1789609173997,"version":"build-2803163510"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2009,12,21]],"date-time":"2009-12-21T00:00:00Z","timestamp":1261353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background:<\/jats:title><jats:p>Transfusion of D+ red blood cells (RBCs) to D\u2212 recipients can be accidental or necessary due to D\u2212 RBC shortage. Alloimmunization can complicate future transfusions; implications for women of childbearing age are compounded by possible hemolytic disease of the fetus and newborn. Rh immunoprophylaxis is effective, and indicated, for preventing alloimmunization. Reports of massive D+ mismatch (e.g., in the case of fetal\u2010maternal bleed) are limited, and standard recommendations for managing these rare events are lacking. The cases discussed herein of women of childbearing age who suffered severe trauma requiring emergency surgery illustrate the dilemma of determining the ideal strategy for Rh immunoprophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case reports:<\/jats:title><jats:p>The first patient received two units of mismatched RBCs and was treated with intravenous Rh immune globulin (IV RHIG; Rhophylac\u00ae, CSL Behring, Kankakee, IL) monotherapy beginning 49 h postsurgery. For the second patient, who received three units of D+ RBCs, partial RBC exchange transfusion, followed 48 h later by IV RHIG, was deemed appropriate based on the large volume of RHIG needed and concerns of hemolytic transfusion reaction and hyperbilirubinemia. Both patients recovered in full without further intervention; the first patient delivered a healthy child \u223c11 months posttreatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Rh immunoprophylaxis is effective, and indicated, for preventing alloimmunization in women of childbearing age to protect the mother, fetus, and newborn. For the general population, a case\u2010by\u2010case approach is recommended. The availability of IV RHIG improves patient safety by facilitating the delivery of such treatment. RBC exchange should be considered for large volume mismatches. J. Clin. Apheresis, 2010. \u00a9 2009 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.20225","type":"journal-article","created":{"date-parts":[[2009,12,21]],"date-time":"2009-12-21T17:59:45Z","timestamp":1261418385000},"page":"70-73","source":"Crossref","is-referenced-by-count":13,"title":["Prevention of Rh sensitization in the context of trauma: Two case reports"],"prefix":"10.1002","volume":"25","author":[{"given":"Jochewed B.","family":"Werch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,12,21]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-7963(88)70039-5"},{"key":"e_1_2_1_3_2","doi-asserted-by":"crossref","first-page":"627","DOI":"10.4049\/jimmunol.132.2.627","article-title":"Cross\u2010linking of B lymphocytes Fc gamma receptors and membrane immunoglobulins inhibits anti\u2010immunoglobulin\u2010induced blastogenesis","volume":"132","author":"Phillips NE","year":"1984","journal-title":"J Immunol"},{"key":"e_1_2_1_4_2","first-page":"565","article-title":"The estimation of the concentration and equilibrium constant of anti\u2010D","volume":"12","author":"Hughes\u2010Jones NC","year":"1967","journal-title":"Immunology"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1957.tb05779.x"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.1971.tb04425.x"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2003.00394.x"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2007.01446.x"},{"key":"e_1_2_1_9_2","first-page":"368","volume-title":"Blood Transfusion in Clinical Medicine","author":"Mollison PL","year":"1983"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2008.01800.x"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-0528.2003.02158.x"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjca.20225","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.20225","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T11:57:04Z","timestamp":1700567824000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.20225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,12,21]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2010,1]]}},"alternative-id":["10.1002\/jca.20225"],"URL":"https:\/\/doi.org\/10.1002\/jca.20225","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,12,21]]}}}