Repeat ABO-incompatible platelet transfusions leading to haemolytic transfusion reaction.
A 65-year-old woman, blood group A RhD positive, who had completed her first course of induction chemotherapy for acute myeloid leukaemia was transfused with apheresis platelets over a number of days. On three occasions she received group O RhD positive units, which had been screened and found not to contain high-titre anti-A,B isoagglutinins. Following the third unit, she developed a haemolytic transfusion reaction and died soon thereafter. This has led to change in policy of the supplying centre in testing for high-titre anti-A,B isoagglutinins. Blood group O apheresis platelets and fresh-frozen plasma units are now labelled as high titre with a cut-off of 1/50 as compared to the previous cut-off of 1/100 for anti-A,B isoagglutinins. A universal approach to testing donations for high-titre anti-A,B isoagglutinins, better compliance of guidelines and monitoring of patients is necessary.
Sadani
D T
DT
National Blood Service, Leeds, UK. deepak.sadani@nbs.nhs.uk
Urbaniak
S J
SJ
Bruce
M
M
Tighe
J E
JE
D000017:ABO Blood-Group System; D000368:Aged; D001781:Blood Component Removal / Q000379:methods; D001787:Blood Group Incompatibility / Q000503:physiopathology*; D017809:Fatal Outcome; D005260:Female; D006461:Hemolysis; D006801:Humans; D007518:Isoantibodies / Q000009:adverse effects* / Q000097:blood; D017713:Platelet Transfusion / Q000009:adverse effects*; D012016:Reference Values
D000017:ABO Blood-Group System; D007518:Isoantibodies