Ask the clinician taking care of the patient the same question and your answer might be similar. Ask the Blood Bank physician responsible for the transfusion what he is afraid of, though, and you would get a list as long as your arm, probably topped off by an Acute Hemolytic Transfusion Reaction (In case you hadn't noticed already, we Blood Bankers spend a lot of time worrying!).
Over the last ten to twenty years, we've gotten much better at preventing transfusion-transmitted infections (through new tests and better donor screening), developed better and more sensitive antibody detection techniques (gel testing, solid phase testing), even seen the impossible happen (hockey teams in Phoenix and Dallas, for crying out loud!), but we haven't done so great (in my opinion) at preventing acute hemolytic transfusion reactions. HTRs account for the vast majority of transfusion-related fatalities, and the sad part is that most of them are entirely preventable! According to a 1997 paper by DeChristopher and Anderson (AJCP 1997;107(Suppl1):S2-S11), acute hemolysis from ABO incompatibility occurs in 1 to 6,000 to 1 in 33,000 transfusions, and is fatal in about 1 in 500,000. Granted, some of these can't be reasonably prevented, and that number does represent improvement over the 1 in 200,000 transfusion risk reported in 1990 by Sazama, but we should not be satisfied.
The following pages discuss the etiology, presentation, lab diagnosis, pathophysiology, treatment, and prevention of acute HTRs.
Back to Transfusion Reaction Types