血液疾患と輸血ジャーナル

概要

Manual Exchange Transfusion: Practical Challenges and Overcomes

Pruthviraj Guduri*, Balwant Kumar, Ipsita Nag, Mekhala Paul, Thejasri Vishnubhatla, Sanjana Sai Makanaboyina

This case report describes the successful use of manual exchange transfusion in the management of a 17-year-old female patient with dapsone-induced methemoglobinemia, which did not respond to conventional therapy with methylene blue and high-dose vitamin C. The patient underwent three cycle of manual exchange transfusion at 12- hour intervals to remove the excess methemoglobin, resulting in significant clinical improvement with the gradual reduction of methemoglobin levels. The manual exchange transfusion each cycle was performed using two units of Anti Hemophilic Globulin (AHG) phase crossmatch compatible Packed Red Blood Cells (PRBC), two units of Random donor platelet (RDP), and one unit of Fresh Frozen Plasma (FFP). The protocol for manual exchange transfusion was followed through a literature review, and the patient was discharged after 15 days of hospitalization with no cyanosis and neurologically intact. This case report highlights the importance of manual exchange transfusion as a potential lifesaving procedure in the acute setting where automated services are unavoidably delayed.