[Perioperative management of a patient with severe anemia caused by rare Jr (a-) blood].

We experienced the anesthetic management of a patient with severe anemia as low as 1.8 g.dl-1 of hemoglobin and 6.5 per cent of hematocrit before surgery. His blood had been determined as type B, anti-Jra antibody positive and the proper blood was unavailable. We gave mainly colloid fluids and partially blood products of different blood groups to maintain the circulating volume with monitoring central venous pressure peri-operatively. The operation finished relatively uneventfully and the patient was transferred to the common ward from the intensive care unit on the fifth postoperative day. We conclude that maintaining the patient's circulating volume to avoid shock should be given priority in a case of severe anemia.