All issues > Volume 15(5); 1972

Original Article

J Korean Pediatr Soc. 1972;15(5):416-423. Published online May 31, 1972.

Changes in Fetal Erythrocytes during and after Exchange Transfusion, and the Relation to Changes of Serum Bilirubin

Kibok Kim¹

¹Department of Pediatrics, Kwangju Christian Hospital, Kwangju, Korea

Abstract

In this study the exchange rates of fetal erythrocytes (Ht>F-containing erythrocytes) in 78 newborn infants who underwent exchange transfusion in this hospital from January to Dec. 1971 were compared with the theoretical exchange rate of blood calculated by Allen* s equation. And the possible relationship between the fluctuation of fetal erythrocytes and the level of serum bilirubin after the exchange transfusion was examined. A very sensitive method of discriminating fetal erythrocytes from adult forms on thin film preparation of blood, utilizing the acid elution technique of Kleihauer et al. was applied. In 67 cases the exchange rate of fetal erythrocytes was significantly higher, (the mean value with standard error being 86. 6%±0. 89%), than the theoretical exchange rate of blood (79.5%±0. 95%). This difference may be caused by the assumption of 10% of body weight for the infant blood volume in calculating the theoretical exchange rate. The infants in which daily fluctuations of fetal erythrocyte content following exchange transfusion were observed, may be categorized into three groups. In the first group which showed a distinct increase in HbF-cell content one or two days after the exchange transfusion, no marked increase in serum bilirubin was observed. In other groups in which either no change in HbF-cell content or distinct decrease in HbF-cell content was observed, the serum bilirubin level tended generally to be high, and often repeated exchange transfusions were necessary. It seems evident, therefore, that the HbF-cell content is a sensitive indicator of continuing hemolysis after exchange transfusion in the hemolytic diseases of newborn. The acid elution technique of demonstrating fetal-hemoglobin containing erythrocytes renders an ideal
method
of assessing the efficiency of exchange transfusion, and gives a simple supportive estimation of prognosis after exchange transfusion in erythroblastosis fetalis.

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