Acute Hemolytic Transfusion Reaction (AHTR), anti-B

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Time to detection: 
10 minutes
Alerting signals, symptoms, evidence of occurrence: 
Case 1: stem cell transplant patient who received one half of a group A plateletpheresis component. Severe back pain occurred 10 minutes into the transfusion, accompanied by anemia and hyperbilirubinemia. Case 2: A second patient who received the other half of the same plateletpheresis component, volume reduced to 37 mL. Syncope occurred immediately after the transfusion, with laboratory evidence of hemolysis a few hours later.
Demonstration of imputability or root cause: 
Serologic investigation of posttransfusion samples from both patients revealed positive direct antiglobulin tests: C3d only for Case 1 and immunoglobulin (Ig)G and C3d for Case 2; the eluates contained anti-B. The group A donor’s anti-B titer was 16,384 at saline and IgG phases.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest new keywords: 
anti-B, C3d
Suggest references: 
Daniel-Johnson, J., Leitman, S., Klein, H., Alter, H., Lee-Stroka, A., Scheinberg, P., Pantin, J. and Quillen, K. (2009). Probiotic-associated high-titer anti-Bin a group A platelet donor as a cause of severe hemolytic transfusion reactions. Transfusion 49:1845-1849.