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Delayed intravascular haemolysis following multiple asymptomatic ABO‐incompatible red blood cell transfusions in a patient with hepatic failure
Author(s) -
Tormey C. A.,
Stack G.
Publication year - 2008
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/j.1423-0410.2008.01085.x
Subject(s) - haemolysis , abo blood group system , medicine , asymptomatic , red blood cell , hemolysis , fresh frozen plasma , red cell , antibody , blood type (non human) , blood transfusion , plasmapheresis , immunology , gastroenterology , platelet
ABO‐incompatible red blood cell (RBC) transfusions have rarely been associated with delayed haemolysis. However, we report the case of a 75‐year‐old man (blood type O) with hepatic disease, who received 5 units of incompatible type B RBCs over 8 days. The patient did not develop symptomatic or biochemical evidence of haemolysis until 7–8 days after the first incompatible RBC unit. The patient had a low anti‐B antibody titre (1 : 64) prior to the first transfusion. The onset of haemolysis was temporally associated with an increase in anti‐B and the infusion of fresh‐frozen plasma. In conclusion, a patient with hepatic failure experienced a delayed haemolytic transfusion reaction after receiving multiple ABO‐incompatible RBC transfusions that were initially well‐tolerated. We speculate that the delayed haemolysis may have resulted from an anamnestic antibody response to the initial incompatible transfusion, or possibly as a result of the transfusion of fresh‐frozen plasma, which might have repleted low complement levels.