II. Epidemiology

  1. Incidence: Up to 5 per 50,000 transfusions
  2. ABO incompatible transfusions are rare (213 events, and 24 deaths between 1996 and 2007)
    1. Vamvakas (2009) Blood 113(15): 3406-17 [PubMed]

III. Types

  1. Intravascular Hemolysis
    1. Major incompatibility: ABO
    2. Immediate and massive Hemolysis
  2. Extravascular Hemolysis
    1. Minor incompatibility: Rh, xKell, xDuffy, xKid
    2. Delayed RBC destruction in reticuloendothelial

IV. Signs: Intravascular Hemolysis (Major Incompatibility)

  1. Rapid and massive Hemolysis to shock state
  2. Restlessness or Anxiety
  3. Flushing
  4. Chest Pain
  5. Back pain
  6. Tachypnea
  7. Tachycardia
  8. Nausea
  9. Renal Failure
  10. Coagulopathy (Disseminated Intravascular Coagulation)

V. Signs: Extravascular Hemolysis (Minor Incompatibility)

  1. Less severe then Intravascular Hemolysis
  2. Malaise
  3. Fever
  4. Shock and Renal Failure are rare
  5. Initially red cell survival normal

VII. Management

  1. Avoid further transfusions if possible
  2. Replace Coagulation Factors as needed
  3. Manage shock and Renal Failure

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Ontology: Hemolytic Transfusion Reaction (C0221123)

Concepts Pathologic Function (T046)
MSH D065227
ICD10 T80.919
SnomedCT 39778006
English Haemolytic transf reaction, Hemolytic transf reaction, hemolytic transfusion reaction (diagnosis), hemolytic transfusion reaction, haemolytic transfusion reaction, transfusion hemolysis, hemolytic reactions transfusion, Hemolytic transfusion reaction NOS, Reactions, Hemolytic Transfusion, Transfusion Reaction, Hemolytic, Hemolytic Transfusion Reactions, Reaction, Hemolytic Transfusion, Hemolytic Transfusion Reaction, Transfusion Reactions, Hemolytic, Haemolytic transfusion reaction, Hemolytic transfusion reaction, Hemolytic transfusion reaction (disorder), Hemolytic transfusion reaction, NOS, Haemolytic transfusion reaction, NOS
Dutch hemolytische reactie op transfusie
French Réaction hémolytique à la transfusion
German haemolytische Transfusionsreaktion
Italian Reazione emolitica trasfusionale
Portuguese Reacção hemolítica à transfusão
Japanese ヨウケツセイユケツハンノウ, 溶血性輸血反応
Czech Hemolytická reakce na transfúzi
Hungarian Haemolyticus transzfúziós reakció
Spanish Reacción hemolítica post-transfusional, reacción hemolítica a una transfusión (trastorno), reacción hemolítica a una transfusión de sangre, reacción hemolítica a una transfusión