The differentiation of delayed hemolytic and delayed serologic transfusion reactions: incidence and predictors of hemolysis.

TitleThe differentiation of delayed hemolytic and delayed serologic transfusion reactions: incidence and predictors of hemolysis.
Publication TypeJournal Article
Year of Publication1995
AuthorsVamvakas EC, Pineda AA, Reisner R, Santrach PJ, Moore SB
JournalTransfusion//Transfusion
Volume35
Issue1
Pagination26 - 32
Date Published1995
ISBN Number0041-1132
Other Numberswdn, 0417360
Keywords*Blood Group Incompatibility/et [Etiology], *Blood Transfusion/ae [Adverse Effects], *Hemolysis, Adult, Aged, Blood Group Antigens/im [Immunology], Blood Group Incompatibility/ep [Epidemiology], Female, Humans, Incidence, Isoantibodies/bl [Blood], Male, Middle Aged
Abstract

BACKGROUND: After differentiation of the entities of clinically detectable delayed hemolytic (DHTR) and delayed serologic transfusion reactions (DSTR), previous investigators calculated a DHTR:DSTR incidence ratio of 18:72 from a retrospective review of patients with serologic evidence of DHTR or DSTR. There are no published data on factors that may influence the occurrence of DHTR versus DSTR in a given patient., STUDY DESIGN AND METHODS: Retrospective review was conducted of 292 patients at the Mayo Clinic who, between 1980 and 1992, received a clinical diagnosis of DHTR or DSTR concurrently with a serologic diagnosis. Red cell alloantibody specificity, the activity of the patient's reticuloendothelial system, and concurrent immunosuppression were evaluated as potential predictors of the occurrence of DHTR versus DSTR in different patients., RESULTS: The incidence of DHTR or DSTR was 1 in 1899 allogeneic red cell units transfused, with a DHTR:DSTR ratio of 36:64. Alloantibody specificity was the only variable that affected the occurrence of DHTR versus DSTR at the clinical level, with the anti-Jka and anti-Fya specificities, as well as multiple coexisting specificities, significantly associated with detectable hemolysis (p

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