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

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Time to detection: 
8-14 days
Alerting signals, symptoms, evidence of occurrence: 
Following an aortic valve replacement requiring 5 units of blood, the patient developed anemia which progressed rapidly. Lab data revealed hemolysis, total bilirubin of 3.4 mg/dl, LDH 612U/L, plasma hemoglobin 11.6g/dl by post operative day 8, increasing by day 15.
Demonstration of imputability or root cause: 
Standard antibody screening showed a negative antibody prior to transfusion. On the 15 day post-op, there was a positive direct Coombs and results of red-cell panel testing documented the specificity of an anti-Jk(b) antibody. The antibody titer was 1:256 two months later.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest new keywords: 
DHTR (delayed hemolytic transfusion reaction)
Reference attachment: 
Suggest references: 
Takeuchi, K, Suzuki, S, Koyama, K, Hatanaka, R, Narita J, Odagiri, S, fukui, K, Takashima, K and Koie, H. (1993). Delayed hemolytic transfusion reaction with anti-Jkb erythrocyte antibody after open heart surgery. The Thoracic and cardiovascular surgeon 41:104-6
Per Daniela: adv. occ. taxonomy: Harm to a recipient/Immunological complications/Delayed Hemolytic Reaction
Expert comments for publication: 
Kidd antibodies, anti-Jk(a), -Jk(b), and -Jk(3), have been responsible for severe and fatal immediate and delayed reactions. The most commonly encountered immune antibodies are D > K> E> Fya> Jka.