Red blood cell transfusion is most commonly given to elderly patients with chronic disorders and uncertain long-term prognoses. The clinical documentation is not infrequently incomplete. There is probably scope for a reduction in consumption if indications are based more on established scientific evidence and well-defined transfusion protocols. Blood group immunisation is not a frequent complication.

No abstract

The red blood cell (RBC) antigen Wr a is a low-prevalence antigen first described in 1953 by Holman and assigned to the Diego system in 1995. Because of its low prevalence, Wr a is usually absent on commercial screening RBCs and antibody identification panels. When Wr(a+) screening RBCs are available, the corresponding antibody, anti-Wr a , is often found in sera from healthy individuals, patients, and pregnant women. Anti-Wr a can cause both hemolytic transfusion reactions and hemolytic disease of the fetus and newborn. We describe a fatal acute hemolytic transfusion reaction caused by anti-Wr a in a patient with no other RBC alloantibodies. Serologic investigation showed that one of the RBC units the patient received was Wr(a+).