02269nas a2200193   4500008003900000245015600039210006900195260000800264520154700272653004701819653004301866653002601909653001801935653002601953100001801979700001501997700001802012856004502030       2018                          d00aAcute haemolysis, DIC and renal failure after transfusion of uncross-matched blood during trauma resuscitation: illustrative case and literature review0 aAcute haemolysis DIC and renal failure after transfusion of uncr  cFeb3 aAIMS/OBJECTIVES:

The aims of this study were to report a patient with acute haemolytic transfusion reaction (HTR) after transfusing uncross-matched red blood cell (RBC) units and to identify the frequency of this complication.
BACKGROUND:

Uncross-matched RBC units are commonly transfused in emergencies, but the frequency of acute HTR is unknown.
METHODS:

We describe a male stabbing victim who received three units of uncross-matched RBC units complicated by acute intravascular HTR, disseminated intravascular coagulation (DIC) and renal failure. We identified 14 studies evaluating the frequency of acute HTR post-emergency transfusion of uncross-matched RBC units.
RESULTS:

Acute HTR was shown by haemoglobinuria, free-plasma haemoglobin and methemalbumin, with anti-K and anti-Fya eluted from recipient red cells; acute DIC featured severe hypofibrinogenemia, thrombocytopenia, elevated fibrin D-dimer and multiple bilateral renal infarcts. Two of the three transfused units reacted with pre-existing RBC alloantibodies [anti-K (titre, 128), anti-Fya (titre, 512)], explained by transfusion 25 years earlier. Our literature review found the frequency of acute HTR following emergency transfusion of uncross-matched RBC units to be 2/3998 [0·06% (95% CI, 0·01-0·21%)].
CONCLUSIONS:

Although emergency transfusion of uncross-matched blood is commonly practiced at trauma centres worldwide, with low risk of acute HTR (<1/1000), our well-documented patient case demonstrates the potential for acute HTR with severe complications.10aalloimmune haemolytic transfusion reaction10adisseminated intravascular coagulation10aemergency transfusion10arenal failure10auncross-matched blood1 aFiorellino, J1 aAL, Elahie1 aWarkentin, TE  uhttps://notifylibrary.org/reference/4682