Visible Hemolysis Check

The visible hemolysis check is very easy to do. Just centrifuge a fresh serum (red top) or plasma (purple top) tube of the patient's post-transfusion blood, and look to see if there is any visible color change.

If positive, the serum should look like the picture on the left below.

 
Positive for free hemoglobin   Negative for free hemoglobin
 
Perhaps the most important thing you can do when you see a post-transfusion sample which looks like the one above is to check the patient's pretransfusion sample to see if it was hemolyzed, too. If the pretransfusion sample looked like the one on the right above, and the posttransfusion sample like the one on the left, then acute hemolysis is a strong consideration.


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