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Record number:
1209
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
DHTR seen in 1/1 patients
Alerting signals, symptoms, evidence of occurrence:
A retrospective study 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. 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 coexisiting specificities, significantly associated with detectable hemolysis (p<0.05).
Demonstration of imputability or root cause:
Serologic diagnosis was based on techniques conforming to the standards of the AABB. DAT was performed on samples obtained before and after transfusion. RBC antibodies were eluted. If a patient had experienced a posttransfusion decrease in the blood hemoglobin level (by at least 1 g/dL from the immediate pretransfusion level), absent obvious, alternative explanation for decrease, adiagnosis of DHTR could be made. If alternative explanations existed, at least one more sign or symptom of hemolysis was required for that diagnosis (see alerting signals).
Imputability grade:
2 Probable
Groups audience:
Keywords:
References:
Suggest new keywords:
DHTR
DSTR
alloimmunization
red blood cell transfusion
Reference attachment:
Suggest references:
Vamvakas, E. C., Pineda, A.A., Reisner, R., Santrach, P.J. and Moore, S.B. (1995). The differentiation of delayed hemolytic and delayed serologic transfusion reactions: incidence and predictors of hemolysis. Transfusion 35(1):26-32; Gupta, S., Fenves, A., Nance, S.T., Sykes, D.B. and Dzik, W.S. (2014). Hyperhemolysis syndrome in a patient without a hemoglobinopathy, unresponsive to treatment with eculizumab. Transfusion DOI: 10.1111/trf.12876.