Acute hemolytic transfusion reaction in a pediatric patient following transfusion of apheresis platelets.
The practice of transfusing ABO-incompatible platelets, driven primarily by concerns about inventory management, has been considered generally safe because the accompanying plasma is usually diluted in the recipient's total blood volume. However, if the platelet product contains a large volume of plasma or a high concentration of incompatible isoagglutinin, there may be hemolysis of the recipient's red cells. Patients with a small blood volume, such as babies and children, are considered to be at particular risk for such a complication. We describe the case of a baby who suffered massive hemolysis of her group A red cells after transfusion of group O Apheresis Platelets containing a high-titered anti-A isoagglutinin. We also offer a review of the literature on this subject and recommendations to avoid acute hemolytic reactions as a result of platelet transfusion.
Sapatnekar
Suneeti
S
American Red Cross Blood Services, Northern Ohio Region, Cleveland, Ohio, USA.
Sharma
Girish
G
Downes
Katharine A
KA
Wiersma
Susan
S
McGrath
Claire
C
Yomtovían
Roslyn
R
D000017:ABO Blood-Group System; D001810:Blood Volume; D020295:Brain Stem Neoplasms / Q000097:blood / Q000150:complications / Q000628:therapy; D002675:Child, Preschool; D005260:Female; D006388:Hemagglutinins / Q000097:blood; D006461:Hemolysis; D006801:Humans; D017713:Platelet Transfusion / Q000009:adverse effects*
D000017:ABO Blood-Group System; D006388:Hemagglutinins