Haemolytic Transfusion Reaction due to Incompatibility without Demonstrable Antibodies

Heistø, H; Myhre, Kåre; Vogt, Else; Heier, Anna‐Margrethe

doi:10.1159/000478604

Cited by 5 publications

(5 citation statements)

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“…In our center and in dealing with referrals from other centers, nationally and internationally, we have used that approach especially when the specificity of the antibody cannot be immediately determined and there is an urgent need for transfusion. Cases consistent with this concept of HTR with no detectable RBC antibody were also reported in the 1960s 10‐12 …”

supporting

confidence: 61%

Do HLA antibodies cause hemolytic transfusion reactions or decreased RBC survival?

Nance¹

2003

Transfusion

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supporting

confidence: 61%

Do HLA antibodies cause hemolytic transfusion reactions or decreased RBC survival?

Nance¹

2003

Transfusion

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“…Hemolytic transfusion reactions in which the donor red cells showed diminished survival by isotope study, but in which no antibody could be demonstrated before or after the transfusion have been reported by Stewart and Mollison13 and Heisto, Myhre, et al 4 Whether the destruction of the red cells here is the result of some unusual, extremely potent qualitative union of antigen and antibody despite a very low quantitative level of antibody, or whether some entirely different process is operative is not apparent.…”

mentioning

confidence: 64%

Delayed Hemolytic Transfusion Reaction Due to Appearance of Multiple Antibodies Following Transfusion of Apparently Compatible Blood

et al. 1964

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A delayed hemolytic transfusion reaction, appearing seven days after transfusions, characterized by jaundice, hemolysis and hemoglobinuria accompanied by the appearance of multiple antibodies in the patient's serum (anti‐hr″ (c) anti‐rh″ (E) and anti‐Jkb) is explained as an anamnestic phenomenon. The original sensitizing antigens and those which precipitated the recall mechanism may be traced to her 20‐year‐old son and to the single‐unit transfusion which she received five years previous to the last admission, and to the transfusions given with the operation from which she recovered. The important fact is that these latent antibodies failed to be detected by standard crossmatching tests (saline, high protein and Coombs) and by a pool of cells containing most of the antigens. The triple enzyme method was the only test which detected the anti‐rh″ (E) antibody. The direct Coombs test became positive at the height of the reaction and persisted for 48 hours. Blood tests after 31/2 and 41/2 months revealed that both the anti‐Jkb and anti‐rh″ (E) antibodies had vanished and only anti‐hr‘ (c) of low titer was still present.

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“…The terms 'hyperhaemolytic' transfusion reaction (HHTR) and "hyperhaemolysis" syndrome are often used to describe cases of more severe haemolysis, where Hb drops below pre-transfusion levels due to destruction of both autologous and transfused RBCs. The first cases of non-sickle HHTR were described over 50 years ago (Stewart & Mollison, 1959;Heisto et al, 1960;van der Hart et al, 1963;Davey et al, 1980) with subsequent cases in SCD (King et al, 1997;Petz et al, 1997). Petz and Garratty (2004a) found that DHTR in SCD frequently manifested with atypical symptoms, such as painful crisis or haemoglobinuria; notably, new allo-antibodes were never detected in 20% of cases, and in 7% they were detected 72 h or longer after haemolysis became evident.…”

Section: Pathophysiologymentioning

confidence: 99%

How we treat delayed haemolytic transfusion reactions in patients with sickle cell disease

Gardner

Hoppe²,

Mijović

et al. 2015

Br J Haematol

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SummaryTransfusion therapy is effective in the prevention and treatment of many complications of sickle cell disease (SCD). However, its benefits must be balanced against its risks, including delayed haemolytic transfusion reactions (DHTR). Not only is the relative rate of alloimmunization higher in patients with SCD than in other patient populations, but attendant risks associated with DHTR are even greater in SCD. Clinicians' awareness of DHTR events is poor because symptoms of DHTR mimic acute vaso-occlusive pain and immunohaematology findings are often negative. Transfusions delivered in the acute rather than elective setting appear to confer a higher risk of DHTR. Management of DHTR in SCD depends on the clinical severity, ranging from supportive care to immunosuppression, and optimization of erythropoiesis. DHTR must be considered in any recently transfused patient presenting with acute sickle cell pain. Meticulous documentation of transfusion and immunohaematology history is key. We anticipate an increase in DHTR events in SCD patients with the increasing use of red blood cell transfusion therapy.

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Haemolytic Transfusion Reaction due to Incompatibility without Demonstrable Antibodies

Cited by 5 publications

References 1 publication

Do HLA antibodies cause hemolytic transfusion reactions or decreased RBC survival?

Do HLA antibodies cause hemolytic transfusion reactions or decreased RBC survival?

Delayed Hemolytic Transfusion Reaction Due to Appearance of Multiple Antibodies Following Transfusion of Apparently Compatible Blood

How we treat delayed haemolytic transfusion reactions in patients with sickle cell disease

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