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The differentiation of delayed serologic and delayed hemolytic transfusion reactions: incidence, long‐term serologic findings, and clinical significance

The differentiation of delayed serologic and delayed hemolytic transfusion reactions: incidence,... Delayed serologic transfusion reactions (DSTRs) and delayed hemolytic transfusion reactions (DHTRs) were studied in a large tertiary‐care hospital. A DSTR was defined by the posttransfusion finding of a positive direct antiglobulin test (DAT) and a newly developed alloantibody specificity. A DHTR was defined as a DSTR case that showed clinical and/or laboratory evidence of hemolysis. Thirty‐four cases of DSTR, 70 percent of which were due to anti‐E and/or ‐Jka, were documented prospectively over a 20‐month period. Retrospective review of the medical records found clinical evidence of hemolysis in only 6 (18%) of the 34. Thus, the incidence of DSTR was 1 (0.66%) of 151 recipients with posttransfusion samples available for testing, whereas the incidence of DHTR was only 1 (0.12%) of 854 patients tested. Fifteen of the 34 patients were followed for up to 174 days after reaction. Twelve of the 15 still demonstrated a positive DAT with anti‐ IgG only. Eluate studies indicated that the persistence of a positive DAT after DSTR or DHTR may involve several immunologic mechanisms, including the development of posttransfusion autoantibodies. This study indicates 1) that DSTRs are a frequent finding in multiply transfused patients, although most cases are benign and fail to meet rigid criteria for DHTR, and 2) that the persistence of a positive DAT after DSTR or DHTR is common. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Transfusion Wiley

The differentiation of delayed serologic and delayed hemolytic transfusion reactions: incidence, long‐term serologic findings, and clinical significance

Ness, Paul M.; Shirey, R. S.; Thoman, S. K.; Buck, S. A.
Transfusion , Volume 30 (8) – Oct 1, 1990
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References (27)

Publisher
Wiley
Copyright
1990 AABB
ISSN
0041-1132
eISSN
1537-2995
DOI
10.1046/j.1537-2995.1990.30891020325.x
Publisher site
See Article on Publisher Site

Abstract

Delayed serologic transfusion reactions (DSTRs) and delayed hemolytic transfusion reactions (DHTRs) were studied in a large tertiary‐care hospital. A DSTR was defined by the posttransfusion finding of a positive direct antiglobulin test (DAT) and a newly developed alloantibody specificity. A DHTR was defined as a DSTR case that showed clinical and/or laboratory evidence of hemolysis. Thirty‐four cases of DSTR, 70 percent of which were due to anti‐E and/or ‐Jka, were documented prospectively over a 20‐month period. Retrospective review of the medical records found clinical evidence of hemolysis in only 6 (18%) of the 34. Thus, the incidence of DSTR was 1 (0.66%) of 151 recipients with posttransfusion samples available for testing, whereas the incidence of DHTR was only 1 (0.12%) of 854 patients tested. Fifteen of the 34 patients were followed for up to 174 days after reaction. Twelve of the 15 still demonstrated a positive DAT with anti‐ IgG only. Eluate studies indicated that the persistence of a positive DAT after DSTR or DHTR may involve several immunologic mechanisms, including the development of posttransfusion autoantibodies. This study indicates 1) that DSTRs are a frequent finding in multiply transfused patients, although most cases are benign and fail to meet rigid criteria for DHTR, and 2) that the persistence of a positive DAT after DSTR or DHTR is common.

Journal

Transfusion – Wiley

Published: Oct 1, 1990

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