Severe immune haemolysis in a group A recipient of a group O red blood cell unit

Transfusion Medicine
M L Barjas-CastroV Castro

Abstract

Haemolysis caused by passive ABO antibodies is a rare transfusional complication. We report a case of severe haemolytic reaction in a 38-year-old man (blood group A) with lymphoma who had received one red blood cell (RBC) unit group O. After transfusion of 270 mL, the patient experienced fever, dyspnoea, chills and back pain. On the following morning he was icteric and pale. Haptoglobin was inferior to 5.8 mgdL(-1), haemoglobin was not increased and lactate dehydrogenase was elevated. Haemolysis was evident on observation of the patient's post-transfusion samples. The recipient's red cells developed a positive direct antiglobulin test and Lui elution showed anti-A coated the cells. Fresh donor serum had an anti-A titre of 1024, which was not reduced by treating the serum with dithiothreitol. Donor isoagglutinin screening has been determined by microplate automated analyser and showed titre higher than 100. Physicians should be aware of the risk of haemolysis associated with ABO-passive antibodies. There is generally no agreement justifying the isoagglutinin investigation prior to transfusion. However, automated quantitative isoagglutinin determination could be part of the modern donor testing process, mainly in blood banks wher...Continue Reading

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Citations

Nov 3, 2005·Journal of Clinical Apheresis·Suneeti SapatnekarRoslyn Yomtovían
Jan 3, 2007·Seminars in Hematology·David F Stroncek
Mar 23, 2017·The Journal of Trauma and Acute Care Surgery·Tamara R BelinAndrew P Cap
May 23, 2013·The Journal of Trauma and Acute Care Surgery·Chelsea R MehrNancy M Dunbar

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