{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:32:22Z","timestamp":1772987542284,"version":"3.50.1"},"reference-count":8,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T00:00:00Z","timestamp":1538006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T00:00:00Z","timestamp":1538006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>A 55\u2010year\u2010old male presented with myelodysplastic\/myeloproliferative neoplasm and severe splenomegaly. The patient is blood group O, D+ with a negative indirect antiglobulin test. Transfusion of 5 units of red blood cells (RBCs) increased the hemoglobin (Hb) level from 6.7 to 7.2 g\/dL. No active bleeding or hemolysis was evident. The patient was readmitted 1 week later with a Hb level of 3.3 g\/dL. An additional 6 units of RBCs showed only an increase from 3.3 to 3.5 g\/dL. Partial splenic embolization was performed, which resulted in a stabilization of the Hb level at approximately 7 g\/dL. Because of this, total splenectomy was performed, which resulted in a gradual increase in Hb level to approximately 13 g\/dL. The patient remains transfusion independent 160 days postsplenectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>RBC transfusion increases Hb concentration by 1 g\/dL per unit in a typical adult. This increase is attenuated in the presence of ongoing hemolysis or active blood loss. Occasionally, a low\u2010RBC\u2010volume unit transfused to a recipient with a large intravascular blood volume may show an unexpectedly small increase. In rare situations, however, the etiology of a greatly attenuated response is more perplexing. The pattern of Hb concentration posttransfusion was suggestive of splenic sequestration in our patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Severe refractoriness to RBC transfusion attributable to severe hypersplenism is a rare event. Our case suggests that splenic artery embolization may be a useful initial approach in individual cases and a potential predictor of the utility of a subsequent surgical splenectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.14876","type":"journal-article","created":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T10:39:18Z","timestamp":1538044758000},"page":"2513-2516","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Refractoriness to red blood cell transfusion therapy due to hypersplenism"],"prefix":"10.1111","volume":"58","author":[{"given":"Ilyas","family":"Sahin","sequence":"first","affiliation":[{"name":"Division of Hematology\u2010Oncology Lifespan Cancer Institute  Providence Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John L.","family":"Reagan","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology Lifespan Cancer Institute  Providence Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabin","family":"Niroula","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology Lifespan Cancer Institute  Providence Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph D.","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine Rhode Island Hospital and The Miriam Hospital, The Warren Alpert Medical School of Brown University  Providence Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,27]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Whitaker BI. The 2011 national blood collection and utilization survey report [Internet]. Washington (DC): US Department of Health and Human Services; 2011 [cited 2018 Sep 13]. Available from:http:\/\/www.aabb.org\/research\/hemovigilance\/bloodsurvey\/Documents\/11-nbcus-report.pdf."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20517"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-121-4-199408150-00009"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1997.37697335150.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1988.tb00861.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI104997"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.56.10.765"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1975.tb02430.x"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftrf.14876","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.14876","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.14876","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.14876","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:02:25Z","timestamp":1772967745000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.14876"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,27]]},"references-count":8,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1111\/trf.14876"],"URL":"https:\/\/doi.org\/10.1111\/trf.14876","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,27]]},"assertion":[{"value":"2018-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}