History
Mrs. A.L., a 91-year-old female, was admitted for left hip surgery
on April 2. Her hemoglobin was 92g/L and two units of RBC were
ordered for her surgery
- Pregnancies:
3 prior pregnancies
- Transfusion: 2 units of RBC
9 years ago with no adverse reactions
April
2
|
Based on these results, Mrs. AL was transfused with
two units of RBC on April 2. No adverse reaction was reported.
June 22
Twelve weeks later, Mrs. AL was admitted to hospital for complication
of the left hip. Two units of RBC were ordered for her surgery.
The transfusion service technologist notified the attending physician
and surgeon that the patient’s antibody screen was positive and
compatible blood would be delayed. The post-transfusion specimen showed no
visible hemolysis or icterus.
Case Summary
and Quiz
After reviewing the case summary, consider these questions.
With regard to delayed hemolytic transfusion
reactions (DHTR):
1. Which antibodies are commonly involved?
2. How long following transfusion do they usually occur?
3. What are the main symptoms?
4. What is the prognosis and treatment?
5. Which non-serological laboratory test results may be helpful
when investigating DHTR?
6. How are such reactions usually discovered and how do they
present in the transfusion service?
Further Reading
Pineda AA, Vamvakas
EC, Gorden LD, Winters JL, Moore SB. Trends in the incidence of delayed
hemolytic and delayed serologic transfusion reactions. Transfusion 1999
Oct;39(10):1097-103. [ Medline
]
Schonewille, H., Haak,
H.L., van Zijl, A.M. Alloimmunization after blood transfusion in patients
with hematologic and oncologic diseases. Transfusion 1999
Jul;39(7):763-71. [ Medline
]
Schonewille H, Haak
HL, van Zijl AM. RBC antibody persistence. Transfusion 2000
Sep;40(9):1127-31. [ Medline
]
Vamvakas EC, Pineda AA, Reisner R, Santrach
PJ, Moore SB. The differentiation of delayed hemolytic and delayed
serologic transfusion reactions: incidence and predictors of hemolysis.
Transfusion 1995 Jan;35(1):26-32. [ Medline
]
