Status:
Ready to upload
Record number:
1250
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Case Report
Time to detection:
12 days
Alerting signals, symptoms, evidence of occurrence:
Patient received 25 mL of O Rh-positive blood and developed flank pain, fever with chills and rigors, and went into shock. Patient also had cola-colored urine.
Demonstration of imputability or root cause:
Patient typed as Le (a-b-). Implicated unit was Le(a+b-). Antibody screen was positive at 37C and AHG phase post transfusion. This reaction was considered as an anamenstic response. It was postulated that the patient was sensitized to Le(a+b-) cells due to the transfusion patient received 12 days prior to this transfusion. One of the four units transfused 12 days ago was Le(a) positive. Unit implicated in this reaction was released by immediate spin saline technique, very likely with no new screen and no crossmatch at 37C or AHG phase.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Reference attachment:
Suggest references:
Thakral, B., Jain, A., Saluja, K., Sharma, R. R., Singh, T.S. and Marwaha, N. (2006). Acute haemolytic transfusion reaction by Le(a) alloantibody. Am J Hematol 81(10):807-808.
Expert comments for publication:
Lewis antibodies rarely cause hemolytic transfusion reactions as they are neutralized by soluble Lewis substances and dissociated Lewis antigens from the donor red cells into plasma of transfused blood. However, anti-Le(a) can cause acute hemolytic reaction when potent at 37C.