Morbidity due to Exchange Transfusion With Heat-Hemolyzed Blood

BLOOD COMPONENTS: Red blood cell hemolysis during blood bank storage: using national quality management data to answer basic scientific questions

“…Now, with the adoption of the “95/95 rule,” the cutoff has essentially fallen to approximately 0.35% hemolysis, because a product developer cannot afford to risk its investment in a product's pivotal trial that had a more than 20% chance of failure just on the basis of random blood donor selection alone. This standard appears to be medically safe, but so was the old one as the normal haptoglobin content of blood is sufficient to efficiently remove the free Hb contained in more than 100 units of RBCs at the end of their storage period 12‐18 . The new standard may provide some additional protection to patients such as those with sickle cell anemia and pulmonary hypertension from chronic hemolysis, but acute pulmonary hypertension is not a reported complication of exchange transfusion in this situation.…”

Investigating non‐immune haemolytic transfusion reactions in surgical patients

“…Philips et al reported non‐immune AHTR in two patients because of accidental overheating of the red cell unit before transfusion 6 . Similar reports of thermal injury resulting in haemolysis and features of AHTR were also reported due to improper heating of red cell units in blood warmers 7–10 . An osmotic cause for AHTR was reported by Shrivastava et al due to intravenous infusion of 5% dextrose through the same red cell transfusion set 11 .…”

“…6 Similar reports of thermal injury resulting in haemolysis and features of AHTR were also reported due to improper heating of red cell units in blood warmers. [7][8][9][10] An osmotic cause for AHTR was reported by Shrivastava et al due to intravenous infusion of 5% dextrose through the same red cell transfusion set. 11 In this case, AHTR was result of osmotic injury to red cells.…”