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[|Human|] hemogloblin, my sister just had her second knee surgery after 14 years her hemoglibin went down below 7 she has received 6 blood transfussion and she is still in the hospital she has a blood clot in the lungs and they started her on cumudin and heprin why is this happening and where is the blood going for it to go so low, her stool has been tested therefore no internal bleeding there was a scan of the knee done therefore it is not in the knee where is it gong and why does it drop so drastically
[|AI|]  Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Hemoglobin after 6 transfusion, if it is still reducing could be due to possible hemolysis - maybe extravascular or intravascular.2. Urine examination, if it shows, blood, possibly intravascular.3. Getting a correct cross-matching of blood sample is necessary. Evaluation of antibodies in patient and antigen in donors RBC is needed. Possible antigen antibody reaction, leading to hemolysis.4. Other cause, which requires evaluation is a possibility of septicemia with disseminated intravascular coagulation. D-dimer test is necessary. More clinical details and reports necessary for further opinion. Hope it helps. Any further queries, happy to help again.