222:(direct Coombs test) which detects IgG antibodies or complement bound to red blood cells and is usually diagnostic of acute hemolytic transfusion reactions. The donor and recipient blood can be re-tested with a type, crossmatch, and antibody screen to determine the cause of the reaction. The donor blood should be examined for any labelling error or other possible errors from the blood bank, which may help prevent other mislabeled blood products from being distributed. Testing the donor blood using a
298:
The severity and prognosis of acute hemolytic transfusion depends on the rate of blood administration and the total volume of the transfusion. The levels of anti-A and anti-B antibodies in the recipients blood may also predict the prognosis, with higher levels of antibodies thought to portend a more
403:
Molthan L, Matulewicz TJ, Bansal-Carver B, Benz EJ (1984). "An immediate hemolytic transfusion reaction due to anti-C and a delayed hemolytic transfusion reaction due to anti-Ce+e: hemoglobinemia, hemoglobinuria and transient impaired renal function".
31:. AHTRs occur within 24 hours of the transfusion and can be triggered by a few milliliters of blood. The reaction is triggered by host antibodies destroying donor red blood cells. AHTR typically occurs when there is an
87:, which is typically due to human error that results in a recipient receiving the incorrect blood product. Rarely, other blood type incompatibilities can cause AHTR, the most common of which is
373:
230:
can also help to rule out an infectious cause of the symptoms (such as the donor receiving infected blood). Testing for urine or plasma free hemoglobin may also assist in the diagnosis.
135:
which leads to pore formation and red blood cell lysis. The lysed red blood cells release free hemoglobin into the bloodstream, overwhelming hemoglobin binding proteins such as
307:
Acute hemolytic transfusion reaction is estimated to occur in 1 in 38,000 to 1 in 70,000 transfusions. An estimated 41% of ABO-incompatible transfusions result in AHTR.
980:
194:, which along with fragments of red blood cells that were destroyed, further stimulate the release of inflammatory cytokines. These inflammatory cytokines include
1025:
210:, which cause increased capillary permeability and vasodilation leading to symptoms of low blood pressure, fever, chest pain, nausea, vomiting, and wheezing.
1155:
867:
464:
Caligiuri, Michael; Levi, Marcel M.; Kaushansky, Kenneth; Lichtman, Marshall A.; Prchal, Josef; Burns, Linda J.; Press, Oliver W. (2015-12-23).
624:
529:
47:(chills). Mild cases are also typically characterized by abdominal, back, flank, or chest pain. More severe cases may be characterized by
862:
166:, which can lead to disseminated intravascular coagulation and kidney damage. Isohemagglutinins also activate the complement cascade via
872:
745:
270:
is the diuretic of choice in treatment of AHTR with decreased urine output, because it increases the amount of blood that reaches the
888:
64:
857:
496:
Jameson, J. Larry; Kasper, Dennis L.; Longo, Dan L.; Fauci, Anthony S.; Hauser, Stephen L.; Loscalzo, Joseph (2018-08-13).
617:
147:, with the excess free hemoglobin leading to renal vasoconstriction (via nitric oxide scavenging), which then leads to
900:
505:
475:
387:
564:
Panch, Sandhya R.; Montemayor-Garcia, Celina; Klein, Harvey G. (11 July 2019). "Hemolytic
Transfusion Reactions".
1150:
238:
Initial treatment for any type of transfusion reaction, including AHTR, is discontinuation of the transfusion.
115:
against A and/or B antigens (isohemagglutinins) present in the recipient's blood destroy the respective donor
43:
Early acute hemolytic transfusion reactions are typically characterized by fever, which may be accompanied by
1160:
685:
610:
935:
789:
299:
severe course. Approximately 2% of cases are fatal. Reactions that begin sooner are typically more severe.
805:
207:
1015:
1010:
975:
955:
910:
852:
832:
822:
1129:
1080:
1060:
707:
171:
132:
71:(blood in the urine) may be the first sign of AHTR. Other symptoms include nausea, vomiting, and
1104:
1050:
945:
923:
670:
148:
84:
32:
1090:
1045:
950:
602:
92:
35:
incompatibility, and is most severe when type A donor blood is given to a type O recipient.
1055:
970:
960:
842:
784:
663:
637:
379:
259:
195:
100:
218:
The diagnosis of AHTR is made with microscopic examination of the recipient's blood and a
8:
1040:
1030:
680:
251:
152:
96:
88:
60:
48:
250:, blood pressure support, and treatment of disseminated intravascular coagulation (with
1070:
589:
523:
429:
417:
354:
341:
324:
128:
1124:
1119:
1005:
702:
633:
593:
581:
511:
501:
471:
421:
383:
358:
346:
242:
and close monitoring of vital signs are important. People with AHTR are managed with
239:
28:
433:
827:
774:
740:
714:
573:
413:
336:
179:
167:
1114:
928:
695:
690:
465:
255:
243:
1000:
895:
810:
770:
735:
287:
116:
56:
515:
1144:
985:
778:
645:
227:
203:
199:
1034:
675:
585:
350:
283:
271:
577:
425:
990:
817:
653:
219:
159:
140:
52:
918:
730:
267:
223:
183:
163:
995:
877:
766:
286:(dilation of blood vessels) in the kidneys as well as increasing the
191:
187:
144:
68:
750:
658:
279:
275:
247:
175:
112:
402:
1109:
1075:
136:
83:
The most common cause of acute hemolytic transfusion reaction is
1020:
463:
371:
72:
44:
632:
1099:
1085:
1065:
1094:
965:
940:
563:
263:
103:
antigen incompatibility have also been implicated in AHTR.
325:"Acute hemolytic transfusion reaction caused by anti-Coa"
322:
124:
120:
495:
262:). The use of steroids, intravenous immune-globulins (
282:
is used for blood pressure support because it causes
372:Hoffbrand, A. V.; P.A.H. Moss; J.E. Pettit (2006).
323:Covin RB, Evans KS, Olshock R, Thompson HW (2020).
290:(amount of blood pumped by the heart each minute).
266:) or plasma exchange is not supported by evidence.
111:Acute hemolytic transfusion reactions result when
1142:
868:Transfusion-associated graft versus host disease
27:, is a life-threatening reaction to receiving a
618:
559:
557:
555:
553:
551:
549:
547:
545:
543:
541:
539:
863:Transfusion associated circulatory overload
316:
67:. In anesthetized or unconscious patients,
1156:Complications of surgical and medical care
873:Febrile non-hemolytic transfusion reaction
746:International Society of Blood Transfusion
625:
611:
528:: CS1 maint: location missing publisher (
498:Harrison's principles of internal medicine
119:. This is mediated through the antibodies
536:
340:
25:immediate hemolytic transfusion reaction
1143:
65:disseminated intravascular coagulation
858:Transfusion related acute lung injury
606:
38:
491:
489:
487:
459:
457:
455:
453:
451:
449:
447:
445:
443:
131:, with complement C5-C9 forming the
21:acute hemolytic transfusion reaction
396:
13:
418:10.1111/j.1423-0410.1984.tb04138.x
375:Essential Haematology: 5th Edition
342:10.21307/immunohematology-2019-543
174:, which then promote inflammatory
14:
1172:
901:Transfusion transmitted infection
484:
440:
158:The antibodies also activate the
16:Complication of blood transfusion
127:) which cause activation of the
566:New England Journal of Medicine
302:
365:
1:
310:
790:Intraoperative blood salvage
293:
233:
213:
182:. C3a and C5a also activate
162:(blood clotting system) via
106:
7:
806:Blood compatibility testing
500:(20th ed.). New York.
10:
1177:
909:
853:Transfusion hemosiderosis
841:
798:
759:
723:
644:
470:. McGraw-Hill Education.
78:
833:Monocyte monolayer assay
220:direct antiglobulin test
123:(and to a lesser extent
708:Granulocyte transfusion
467:Williams Hematology, 9E
133:membrane attack complex
149:acute tubular necrosis
59:, and may progress to
1151:Transfusion reactions
843:Transfusion reactions
578:10.1056/NEJMra1802338
1161:Transfusion medicine
823:Kleihauer–Betke test
785:Exchange transfusion
664:Platelet transfusion
638:transfusion medicine
380:Blackwell Publishing
260:platelet transfusion
246:, which may include
23:(AHTR), also called
911:Blood group systems
846:and adverse effects
681:Fresh frozen plasma
252:fresh frozen plasma
160:coagulation cascade
153:acute kidney injury
85:ABO incompatibility
49:shortness of breath
278:may also be used.
129:complement cascade
53:low blood pressure
39:Signs and symptoms
1138:
1137:
715:Blood substitutes
703:White blood cells
634:Blood transfusion
240:Fluid replacement
180:white blood cells
91:incompatibility.
29:blood transfusion
1168:
828:Antibody elution
775:plateletpheresis
741:Blood management
724:General concepts
627:
620:
613:
604:
603:
598:
597:
561:
534:
533:
527:
519:
493:
482:
481:
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329:Immunohematology
320:
1176:
1175:
1171:
1170:
1169:
1167:
1166:
1165:
1141:
1140:
1139:
1134:
929:Secretor status
905:
845:
837:
794:
755:
719:
696:Cryosupernatant
691:Cryoprecipitate
671:Red blood cells
640:
631:
601:
562:
537:
521:
520:
508:
494:
485:
478:
462:
441:
401:
397:
390:
370:
366:
321:
317:
313:
305:
296:
256:cryoprecipitate
244:supportive care
236:
216:
117:red blood cells
109:
81:
41:
33:ABO blood group
17:
12:
11:
5:
1174:
1164:
1163:
1158:
1153:
1136:
1135:
1133:
1132:
1127:
1122:
1117:
1112:
1107:
1102:
1097:
1088:
1083:
1078:
1073:
1068:
1063:
1058:
1053:
1048:
1043:
1038:
1028:
1023:
1018:
1013:
1008:
1003:
998:
993:
988:
983:
978:
973:
968:
963:
958:
953:
948:
943:
938:
933:
932:
931:
921:
915:
913:
907:
906:
904:
903:
898:
896:Serum sickness
893:
892:
891:
886:
875:
870:
865:
860:
855:
849:
847:
839:
838:
836:
835:
830:
825:
820:
815:
814:
813:
811:Cross-matching
802:
800:
796:
795:
793:
792:
787:
782:
771:plasmapheresis
763:
761:
757:
756:
754:
753:
748:
743:
738:
736:Blood donation
733:
727:
725:
721:
720:
718:
717:
712:
711:
710:
700:
699:
698:
693:
688:
683:
673:
668:
667:
666:
656:
650:
648:
646:Blood products
642:
641:
630:
629:
622:
615:
607:
600:
599:
572:(2): 150–162.
535:
506:
483:
476:
439:
395:
388:
364:
314:
312:
309:
304:
301:
295:
292:
288:cardiac output
235:
232:
215:
212:
186:which release
108:
105:
80:
77:
57:hemoglobinuria
40:
37:
15:
9:
6:
4:
3:
2:
1173:
1162:
1159:
1157:
1154:
1152:
1149:
1148:
1146:
1131:
1128:
1126:
1123:
1121:
1118:
1116:
1113:
1111:
1108:
1106:
1103:
1101:
1098:
1096:
1092:
1089:
1087:
1084:
1082:
1079:
1077:
1074:
1072:
1069:
1067:
1064:
1062:
1059:
1057:
1054:
1052:
1049:
1047:
1044:
1042:
1039:
1036:
1032:
1029:
1027:
1024:
1022:
1019:
1017:
1014:
1012:
1009:
1007:
1004:
1002:
999:
997:
994:
992:
989:
987:
984:
982:
979:
977:
974:
972:
969:
967:
964:
962:
959:
957:
954:
952:
949:
947:
946:Chido-Rodgers
944:
942:
939:
937:
934:
930:
927:
926:
925:
922:
920:
917:
916:
914:
912:
908:
902:
899:
897:
894:
890:
887:
885:
882:
881:
879:
876:
874:
871:
869:
866:
864:
861:
859:
856:
854:
851:
850:
848:
844:
840:
834:
831:
829:
826:
824:
821:
819:
816:
812:
809:
808:
807:
804:
803:
801:
797:
791:
788:
786:
783:
780:
779:leukapheresis
776:
772:
768:
765:
764:
762:
758:
752:
749:
747:
744:
742:
739:
737:
734:
732:
729:
728:
726:
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713:
709:
706:
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704:
701:
697:
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679:
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672:
669:
665:
662:
661:
660:
657:
655:
652:
651:
649:
647:
643:
639:
635:
628:
623:
621:
616:
614:
609:
608:
605:
595:
591:
587:
583:
579:
575:
571:
567:
560:
558:
556:
554:
552:
550:
548:
546:
544:
542:
540:
531:
525:
517:
513:
509:
507:9781259644030
503:
499:
492:
490:
488:
479:
477:9780071833004
473:
469:
468:
460:
458:
456:
454:
452:
450:
448:
446:
444:
435:
431:
427:
423:
419:
415:
412:(5): 348–53.
411:
407:
399:
391:
389:1-4051-3649-9
385:
381:
377:
376:
368:
360:
356:
352:
348:
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291:
289:
285:
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277:
273:
269:
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257:
253:
249:
245:
241:
231:
229:
228:blood culture
225:
221:
211:
209:
205:
201:
197:
193:
189:
185:
181:
178:release from
177:
173:
169:
165:
161:
156:
154:
150:
146:
142:
138:
134:
130:
126:
122:
118:
114:
104:
102:
98:
94:
90:
86:
76:
74:
70:
66:
62:
58:
54:
50:
46:
36:
34:
30:
26:
22:
883:
569:
565:
497:
466:
409:
405:
398:
374:
367:
332:
328:
318:
306:
303:Epidemiology
297:
284:vasodilation
272:renal cortex
237:
217:
157:
110:
89:Kidd antigen
82:
42:
24:
20:
18:
919:Blood types
818:Coombs test
654:Whole blood
335:(2): 45–9.
141:haptoglobin
1145:Categories
731:Blood bank
516:1029074059
311:References
268:Furosemide
224:gram stain
184:mast cells
164:factor XII
113:antibodies
936:Augustine
880:reaction
878:Hemolytic
767:Apheresis
659:Platelets
594:261097623
524:cite book
359:235243237
294:Prognosis
248:diuretics
234:Treatment
214:Diagnosis
208:TNF-alpha
192:histamine
188:serotonin
145:hemopexin
107:Mechanism
69:hematuria
1061:Lutheran
966:Dombrock
751:ISBT 128
586:31291517
434:41434530
406:Vox Sang
351:15373591
280:Dopamine
276:Mannitol
176:cytokine
73:wheezing
1100:Scianna
986:Gerbich
889:delayed
760:Methods
426:6438912
137:albumin
1011:Indian
956:Cromer
951:Colton
676:Plasma
592:
584:
514:
504:
474:
432:
424:
386:
357:
349:
258:, and
206:, and
143:, and
99:, and
79:Causes
45:rigors
1130:Other
1056:Lewis
1046:Knops
1026:KANNO
971:Duffy
961:Diego
884:acute
799:Tests
590:S2CID
430:S2CID
355:S2CID
101:Duffy
61:shock
1110:T-Tn
1095:RHAG
1093:and
1086:Raph
1081:P1PK
1041:Kidd
1031:Kell
996:GLOB
981:FORS
941:CD59
686:PF24
636:and
582:PMID
530:link
512:OCLC
502:ISBN
472:ISBN
422:PMID
384:ISBN
347:PMID
264:IVIG
226:and
204:IL-8
200:IL-6
196:IL-1
190:and
170:and
151:and
97:Kell
63:and
1115:Vel
1105:Sid
1071:MNS
1051:Lan
1021:JMH
991:GIL
924:ABO
574:doi
570:381
414:doi
337:doi
172:C5a
168:C3a
125:IgG
121:IgM
19:An
1147::
1125:Yt
1120:Xg
1091:Rh
1076:OK
1066:LW
1035:Xk
1016:JR
1006:Ii
1001:Hh
976:Er
777:,
773:,
588:.
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