title: Acute hemolytic transfusion reactions--a fresh look at pathogenesis and considerations regarding therapy.
abstract: A review of our knowledge of acute hemolytic transfusion reactions indicates that we have learned much in recent years about the pathogenetic mechanisms involved. An approach to effective therapy for patients suffering such reactions should be based on our latest understanding of the pathophysiology of this syndrome. However, changes in our therapeutic approach have not kept abreast of our increased awareness of the etiologic factors, and the patient, therefore, is not getting the benefit of our increased knowledge in this area. The primary pathogenetic mechanisms involved in these reactions appear to be disseminated intravascular coagulation and a series of hemodynamic alterations leading to ischemic necrosis of tissues. Therapy would best be aimed at interfering with these primary pathophysiologic pathways.
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000743:Anemia, Hemolytic / Q000209:etiology*; D001778:Blood Coagulation Disorders / Q000209:etiology; D001787:Blood Group Incompatibility / Q000150:complications*; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000209:etiology; D004231:Diuresis / Q000187:drug effects; D004912:Erythrocytes / Q000276:immunology; D004976:Ethacrynic Acid / Q000627:therapeutic use; D005665:Furosemide / Q000627:therapeutic use; D006474:Hemorrhagic Disorders / Q000209:etiology; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007678:Kidney Glomerulus / Q000503:physiopathology; D008353:Mannitol / Q000627:therapeutic use; D065227:Transfusion Reaction
chemical_list: D008353:Mannitol; D005665:Furosemide; D006493:Heparin; D004976:Ethacrynic Acid