| Autologous Blood Donation and
Open Heart Surgery in a Patient with Ischemic Heart Disease and
Type I CD36 Deficiency |
(Department of Cardiovascular Surgery, Shiga National
Hospital, Yokaichi, Japan)
| Satoru Okumura |
Jun Okawara |
Yoshinobu Maeda |
|
In patients with type I CD36 deficiency,
immunization with CD36 antigen (Naka) through pregnancy
or transfusion, could produce anti-CD36 antibody (anti-Naka),
and potentially lead to platelet transfusion refractoriness or
posttransfusion purpura. We report a 72-year-old woman who had
no history of pregnancy or previous blood transfusions. She had
been treated medically for hypertension and heart failure since
the age of 65 years. Type I CD36 deficiency was also diagnosed
based on the findings of 123I-β-methyl-iodophenyl
pentadecanoic acid cardiac scintigraphy. At 72 years of age,
she suffered acute thromboembolism in the left external iliac
artery. The thrombus was removed and a left external iliac artery
to left superficial femoral artery bypass was performed without
any blood transfusion. Echocardiography, left ventriculography
and coronary angiography showed left ventricular aneurysm and
coronary artery disease. Resection of the left ventricular aneurysm
and coronary artery bypass grafting were performed without donor
blood transfusion. Autotransfusion by autologous blood donation
and intraoperative autologous blood transfusion was used to avoid
sensitization by the CD36 antigen through donor blood transfusion.
Autotransfusion should be performed to avoid complications associated
with donor blood transfusion particularly in patients with type
I CD36 deficiency.
Jpn. J. Cardiovasc. Surg. 32: 297 -299 (2003) |
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