title: Risk of hemolytic transfusion reactions following emergency-release RBC transfusion.
abstract: Group O RBCs are typically issued for urgent transfusions to avoid ABO-incompatible hemolytic transfusion reactions (HTRs). Identification of other clinically significant alloantibodies requires an antibody detection test, and emergency release (ER) of RBCs before its completion carries a risk of non-ABO alloantibody-mediated HTRs. We performed a retrospective review of 1,002 ER RBC transfusions involving 265 ER episodes (262 recipients) in a tertiary medical center, 2006-2008, to determine the risk of non-ABO alloantibody-mediated HTRs. A positive antibody detection test was found in 29 (10.9%) of 265 ER episodes, with clinically significant alloantibodies in 17 (6.4%) of 265 ER episodes. Fifteen antigen-incompatible RBC units were transfused to 7 recipients with clinically significant alloantibodies; 1 transfusion was followed by an HTR. Based on our study, transfusion of ER RBCs before completion of routine blood bank testing carries a low risk of non-ABO alloantibody-mediated HTRs (1/265 [0.4% ER episodes]) and receipt of antigen-incompatible RBCs (7/265 [2.6% ER episodes]).
authors.affiliation: Dept. of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
authors.forename: Pamela P
authors.initials: PP
authors.lastname: Goodell
authors.forename: Lynne
authors.initials: L
authors.lastname: Uhl
authors.forename: Monique
authors.initials: M
authors.lastname: Mohammed
authors.forename: Amy A
authors.initials: AA
authors.lastname: Powers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001787:Blood Group Incompatibility / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D006461:Hemolysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007518:Isoantibodies / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007518:Isoantibodies