Delayed Hemolytic Transfusion Reaction (DHTR), anti-Jk(b), renal failure

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Time to detection: 
13 days
Alerting signals, symptoms, evidence of occurrence: 
Fever, hemoglobinemia, hemoglobinuria, oliguria, and a marked fall in hematocrit values developed in a patient with a bleeding peptic ulcer 13 days after he had received 4 units of apparently compatible blood. He went on to become frankly uremic and hyperkalemic, but eventually recovered.
Demonstration of imputability or root cause: 
Results of routine serologic studies at the time of the transfusion reaction were normal, but an anti-Jkb antibody could be demonstrated when cells treated with trypsin were used in the indirect Coombs' test; the patient's blood type was found to be Jk(a+b-); the blood type of three of his four donors was Jk(b+).
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest references: 
Holland, P.V. and Wallerstein, R.O (1968). Delayed hemolytic transfusion reaction with acute renal failure. JAMA 204(11),1007-1008.