Abstract

1. In the authors’ technic of exchange transfusion, citrated blood is introduced into the saphenous vein at the ankle and the infant’s blood simultaneously withdrawn from the radial artery at the wrist, coagulation being prevented by the administration of small amounts of heparin. The procedure besides being simple, is safe, there having been no operative mortality in more than 40 transfusions.

2. The results of exchange transfusion therapy in erythroblastosis in our first 28 cases are presented. Of these 28 cases, 16 were very severe and almost certainly would have been lethal if left untreated, 6 were of moderate severity, and 6 were mild. Only 7 of the infants died, and the available data indicate that the mortality would have been at least twice as high had the usual treatment with simple transfusions been given.

3. Aside from its greater efficacy in reducing mortality, exchange transfusion is more efficient, so that supplementary treatment is not required as a rule.

4. Fresh blood should be used instead of bank blood because of its greater survival time and smaller likelihood of introducing infection.

5. All infants who have survived have developed normally both physically and mentally and have shown no sequelae of liver or brain damage.

6. The most reliable index of the severity of the disease in the erythroblastotic infant is provided by antenatal titrations of the maternal univalent Rh antibodies, as well as by tests for the presence of univalent antibodies in the infant’s blood.

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