Acute Hemolytic Transfusion Reaction (AHTR), anti-A1

Status:

Ready to upload

Record number:

1256

Adverse Occurrence type:

Acute Hemolytic Reaction

MPHO Type:

Red blood cells

Estimated frequency:

Case Report

Time to detection:

25 minutes

Alerting signals, symptoms, evidence of occurrence:

Twenty-five minutes (60 mL) into the transfusion the patient developed back pain, dyspnea, wheeze, chills and rigors.

Demonstration of imputability or root cause:

Post transfusion plasma sample demonstrated hemoglobinemia. Positive direct antiglobulin test with elution of anti-A1 from the RBCs. Post transfusion decrease in hemoglobin and increased lactate dehydrogenase (LDH) levels

Imputability grade:

2 Probable

Groups audience:

Clinical complications

Keywords:

AHTR (acute hemolytic transfusion reaction)

DAT (direct antiglobulin test)

anti-A1

References:

Transfusion medicine illustrated. A bloody mistake: unrecognized warm reactive anti-A1 resulting in acute hemolytic transfusion reaction.

Suggest new keywords:

Anti-A1

A2B

hemolysis

Reference attachment:

* AHTR A1, Preece, 2011.pdf

Suggest references:

Preece, J., Magrin, G., Webb, A., Akers,C. and Davis, A. Transfusion medicine illustrated. A bloody mistake: unrecognized warm reactive anti-A1 resulting in acute hemolytic transfusion reaction. Transfusion 51(5):914-915.

Expert comments for publication:

A case report, where the presence of warm reacting anti-A1 was missed as the reaction pattern observed was attributed to transfusion of B plasma in a AB patient. This anti-A1 resulted in acute hemolytic reaction. It is not clear why the patient was not typed as A2B with interfering anti-A1 earlier. Patient received autologous bone marrow transplant for myeloma and should have been typed before the transplant.