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Lee, Hwang, Lee, Kim, Park, and Song: Transfusion-free Management for the Severe Anemia Developed after Nephrectomy
Case Report

The Ewha Medical Journal 2015; 38(2): 69-71.

Published online: 29 July 2015

DOI: https://doi.org/10.12771/emj.2015.38.2.69

Transfusion-free Management for the Severe Anemia Developed after Nephrectomy

Minjoo Lee, Changhyeok Hwang, Ji Hoon Lee, Seok-hyung Kim, Hae Yeul Park, Young Goo Song

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author: Young Goo Song. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 135-720, Korea. Tel: 82-2-2019-3319, Fax: 82-2-3463-3882, imfell@yuhs.ac

Received 4 February 2015       Accepted 14 May 2015

Copyright © 2015, The Ewha Medical Journal

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 56-year-old woman with emphysematous pyelonephritis underwent an emergent left nephrectomy due to her religious creed. Postoperative hemoglobin level was decreased to 4.4 g/dL from preoperative value of 13.9 g/dL. The patient completely recovered without transfusion and was discharged on the 40th postoperative day without complication.

Keywords: Nephrectomy, Anemia, Transfusion free

Figures and Tables

Fig. 1

Computed tomography of abdomen-pelvis. It shows empysematous pyelonephritis (arrow).

emj-38-69-g001
Fig. 2

Changes in hematocrit (Hct) and hemoglobin (Hb) levels of a patient during preoperative (Preop) and postoperative period (POD, postoperative day).

emj-38-69-g002

References

1. Narlawar RS, Raut AA, Nagar A, Hira P, Hanchate V, Asrani A. Imaging features and guided drainage in emphysematous pyelonephritis: a study of 11 cases. Clin Radiol. 2004; 59:192–197.
2. Michaeli J, Mogle P, Perlberg S, Heiman S, Caine M. Emphysematous pyelonephritis. J Urol. 1984; 131:203–208.
3. Pontin AR, Barnes RD. Current management of emphysematous pyelonephritis. Nat Rev Urol. 2009; 6:272–279.
4. Park BS, Lee SJ, Kim YW, Huh JS, Kim JI, Chang SG. Outcome of nephrectomy and kidney-preserving procedures for the treatment of emphysematous pyelonephritis. Scand J Urol Nephrol. 2006; 40:332–338.
5. Koh KB, Lam HS, Lee SH. Emphysematous pyelonephritis: drainage or nephrectomy? Br J Urol. 1993; 71:609–611.
6. Bodnaruk ZM, Wong CJ, Thomas MJ. Meeting the clinical challenge of care for Jehovah's Witnesses. Transfus Med Rev. 2004; 18:105–116.
7. Goodnough LT, Brecher ME, Kanter MH, AuBuchon JP. Transfusion medicine. First of two parts: blood transfusion. N Engl J Med. 1999; 340:438–447.
8. Isbister JP, Shander A, Spahn DR, Erhard J, Farmer SL, Hofmann A. Adverse blood transfusion outcomes: establishing causation. Transfus Med Rev. 2011; 25:89–101.
9. Blajchman MA. Allogeneic blood transfusions, immunomodulation, and postoperative bacterial infection: do we have the answers yet? Transfusion. 1997; 37:121–125.
10. Musallam KM, Tamim HM, Richards T, Spahn DR, Rosendaal FR, Habbal A, et al. Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet. 2011; 378:1396–1407.
11. Goodnough LT, Shander A, Spence R. Bloodless medicine: clinical care without allogeneic blood transfusion. Transfusion. 2003; 43:668–676.
12. Goodnough LT, Brittenham GM. Limitations of the erythropoietic response to serial phlebotomy: implications for autologous blood donor programs. J Lab Clin Med. 1990; 115:28–35.
13. Goodnough LT, Skikne B, Brugnara C. Erythropoietin, iron, and erythropoiesis. Blood. 2000; 96:823–833.
14. Carson JL, Noveck H, Berlin JA, Gould SA. Mortality and morbidity in patients with very low postoperative Hb levels who decline blood transfusion. Transfusion. 2002; 42:812–818.
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