Massive transfusion during major surgery in a child with anti-Knopsa and one kidney.

Massive transfusion has been defined as the replacement of one-third to one-half of the blood volume of the patient. It usually implies the presence of shock and is associated with multiple traumatic injuries. Blood replacement is almost always banked blood given in large quantities. However, massive transfusion with autologous blood can also be applied to elective cases and is becoming a useful and clinically beneficial service both in the quality of the products transfused service both in the quality of the products transfused and avoidance of diseases transmitted by blood transfusion from heterologous blood donor sources. Operations which regularly require the transfusion of three or more units of blood include open heart surgery, orthopedic reconstructive procedures, vascular surgery and abdominal surgical procedures. The case presented here, an orthopedic procedure, describes an example of elective massive transfusion, successfully performed in the presence of a rare alloantibody to red blood cells.