Delayed Hemolytic Reactions
PREVENTION: Based on what you already know about DHTRs from our previous discussion, you realize that this section could easily be fairly short! In truth, in most cases, we can't do anything to prevent a delayed hemolytic reaction.
Since the majority of DHTRs result from the reappearance of an antibody that by definition, we could not detect, you could say that we are all operating with the possibility that a transfusion reaction could occur with any transfusion. Obviously, if a patient has a known history of a significant antibody, blood that is negative for the target antigen should always be given (even if the antibody is not currently detectable). However, as we discussed earlier, if a particular Transfus ion Service has never seen a patient, there is no way to know about a previous antibody that has faded to undetectable levels.
Based on what you already know about DHTRs from our previous discussion, you realize that this section could easily be fairly short! In truth, in most cases, we can't do anything to prevent a delayed hemolytic reaction. Since the majority of DHTRs result from the reappearance of an antibody that by definition, we could not detect, you could say that we are all operating with the possibility that a transfusion reaction could occur with any transfusion. Obviously, if a patient has a known history of a significant antibody, blood that is negative for the target antigen should always be given (even if the antibody is not currently detectable). However, as we discussed earlier, if a particular Transfusion Service has never seen a patient, there is no way to know about a previous antibody that has faded to undetectable levels.
With that being said, blood bankers are trying to do some things that may be helpful. A nationwide trend toward more sensitive antibody screening technology such as the Ortho ID-MTS (gel) system or the Immucor Capture-R system may lead to more low-level antibodies being detected. To my knowledge, that has not been proven yet, but logically, it seems that a more sensitive screening test may pick up more antibodies that we may have missed in the past.
I have also heard of different blood banks actually giving patients who have antibodies little cards detailing their antibody information, in case they go to another facility for transfusion. This is a nice service, but I don't know of many places that are doing it.
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