Delayed Hemolytic Transfusion Reaction (DHTR), anti-Kell

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Case report
Time to detection: 
12 days
Alerting signals, symptoms, evidence of occurrence: 
A 54-year-old woman received 2 units of blood during an orthopedic procedure. The patient returned 12 days after the transfusion with a Hb level of 54 g per L, pallor, jaundice, fatigue and diarrhea.
Demonstration of imputability or root cause: 
Antibody investigations demonstrated an anti-K with a positive DAT and anti-K detected in the eluate from the red cells.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
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Reference attachment: 
Suggest references: 
Xenocostas, A, Callum, JL, Coovadia, AS and Reis MD. (2002). Prolonged in vitro hemolysis of EDTA-anticoagulated blood after a delayed hemolytic transfusion reaction. Transfusion 42:1086-8
Expert comments for publication: 
In the Kell system, anti-K, -k, and -Ku have caused severe immediate hemolytic transfusion reactions. All other Kell antibodies should be considered to have the potential to cause HTRs, although these are likely to be delayed. The most commonly encountered immune antibodies are D > K> E> Fya> Jka.