Acute hemolytic transfusion reaction

Acute Hemolytic Transfusion Reaction (AHTR) is a severe complication that can occur during a blood transfusion. It is characterized by the rapid destruction of red blood cells (RBCs) that can lead to serious health problems such as kidney failure and shock.

Causes

AHTR is most commonly caused by the transfusion of ABO incompatible blood, which means the donor's blood type does not match the recipient's. This can occur due to errors in blood typing or crossmatching procedures. Other causes include the transfusion of blood that has been contaminated with bacteria or that is incompatible in other blood group systems.

Symptoms

The symptoms of AHTR can vary widely, but often include fever, chills, chest or back pain, nausea, and dark urine. In severe cases, patients may experience hypotension, tachycardia, disseminated intravascular coagulation (DIC), and acute kidney injury.

Diagnosis

Diagnosis of AHTR is based on clinical symptoms and laboratory findings. Laboratory tests may show an increase in bilirubin levels, a decrease in haptoglobin levels, and the presence of free hemoglobin in the urine. A direct antiglobulin test (DAT) may also be positive.

Treatment

Treatment of AHTR involves stopping the transfusion immediately and providing supportive care. This may include intravenous fluids, oxygen, and medications to control symptoms. In severe cases, dialysis may be required.

Prevention

Prevention of AHTR involves careful blood typing and crossmatching procedures to ensure that the donor's blood is compatible with the recipient's. In addition, blood products should be properly stored and handled to prevent bacterial contamination.

See also

• Blood transfusion
• Transfusion reaction
• Hemolysis
• ABO blood group system