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Upon completion of this exercise, participants should be able to:
A 60-year-old female (SJ) was admitted to hospital complaining of bloody diarrhea and dizziness. Two days later she experienced severe GI bleeding and underwent emergency surgery. A crossmatch for 6 units of RBC was ordered.
* As used for this case study, Day 0 is the day of the first transfusion. Day 3, etc., refers to days post-transfusion.
The technologist notified the attending physician that the patient had an unexpected antibody (or antibodies) present but that units crossmatched by indirect antiglobulin method were compatible and available if needed. Because the transfusion service performs only Type and Screen/Crossmatch the samples were sent to a reference laboratory to have the antibody identified.
Reference laboratory results (Reported on Day 3)
On Day 8 SJ's condition deteriorated. Peripheral blood smears were consistent with acute hemolysis (anisocytosis, poikilocytosis, nucleated RBCs). Her reticulocyte count was 8.8 percent.
Additional laboratory results (Day 8)
See the case discussion, including interactive questions with feedback.
This quiz is offered as a self assessment.
Cash KL, Brown T, Sausais L, Uehlinger J, Reed LJ.Severe delayed hemolytic transfusion reaction secondary to anti-At(a). Transfusion 1999 Aug;39(8)834-7. [Medline]
Davenport RD. Hemolytic transfusion reactions. In: Popovsky M, editor. Transfusion reactions, 2nd ed. Arlington, VA: AABB Press;2001. p.1-44.
Heddle NM, Soutar RL, O'Hoski PL, Singer J, McBride JA, Ali MA, Kelton JG. A prospective study to determine the frequency and clinical significance of alloimmunization post-transfusion. Br J Haematol 1995 Dec;91(4):1000-5. [ Medline ]
Hillman NM. Fatal delayed hemolytic transfusion reaction due to anti-c + E. Transfusion 1979 Sep-Oct;19(5)548-51. [ Medline ]
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 ]
Sazama K. Reports of 355 transfusion associated deaths:1976 through 1985. Transfusion 1990;30:583-90. [ Medline ]
Schonewille H, Haak HL, van Zijl AM. RBC antibody persistence. Transfusion 2000 Sep;40(9):1127-31. [ Medline ]