Hemolytic transfusion reaction
Encyclopedia
An acute hemolytic transfusion reaction (AHTR) is a type of transfusion reaction that is associated with hemolysis
.
It occurs very soon after the transfusion. It can occur quickly upon transfusing a few milliliters, or up to 1-2 hours post-transfusion.
It is also known as an "immediate hemolytic transfusion reaction".
This is a medical emergency as it results from rapid destruction of the donor red blood cells by host antibodies (IgG, IgM). It is usually related to ABO blood group incompatibility - the most severe of which often involves group A red cells being given to a patient with group O type blood. Properdin then binds to complement C3 in the donor blood, facilitating the reaction through the alternate pathway cascade. The donor cells also become coated with IgG and are subsequently removed by macrophages in the reticuloendothelial system (RES). Jaundice
and disseminated intravascular coagulation
(DIC) may also occur.
The most common cause is clerical error (i.e. the wrong unit of blood being given to the patient). The symptoms are fever and chills, sometimes with back pain and pink or red urine (hemoglobinuria). The major complication is that the hemoglobin, released by the destruction of red blood cells, may cause acute renal failure (also known as the "oliguric phase").
About 20 annual deaths in the US are due to AHTR.
Hemolysis
Hemolysis —from the Greek meaning "blood" and meaning a "loosing", "setting free" or "releasing"—is the rupturing of erythrocytes and the release of their contents into surrounding fluid...
.
It occurs very soon after the transfusion. It can occur quickly upon transfusing a few milliliters, or up to 1-2 hours post-transfusion.
It is also known as an "immediate hemolytic transfusion reaction".
This is a medical emergency as it results from rapid destruction of the donor red blood cells by host antibodies (IgG, IgM). It is usually related to ABO blood group incompatibility - the most severe of which often involves group A red cells being given to a patient with group O type blood. Properdin then binds to complement C3 in the donor blood, facilitating the reaction through the alternate pathway cascade. The donor cells also become coated with IgG and are subsequently removed by macrophages in the reticuloendothelial system (RES). Jaundice
Jaundice
Jaundice is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae , and other mucous membranes caused by hyperbilirubinemia . This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluid...
and disseminated intravascular coagulation
Disseminated intravascular coagulation
Disseminated intravascular coagulation , also known as disseminated intravascular coagulopathy or consumptive coagulopathy, is a pathological activation of coagulation mechanisms that happens in response to a variety of diseases. DIC leads to the formation of small blood clots inside the blood...
(DIC) may also occur.
The most common cause is clerical error (i.e. the wrong unit of blood being given to the patient). The symptoms are fever and chills, sometimes with back pain and pink or red urine (hemoglobinuria). The major complication is that the hemoglobin, released by the destruction of red blood cells, may cause acute renal failure (also known as the "oliguric phase").
About 20 annual deaths in the US are due to AHTR.