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Blood compatibility testing is routinely performed before a blood transfusion.The full compatibility testing process involves ABO and RhD (Rh factor) typing; screening for antibodies against other blood group systems; and crossmatching, which involves testing the recipient's blood plasma against the donor's red blood cells as a final check for incompatibility.
An acute hemolytic transfusion reaction (AHTR), also called immediate hemolytic transfusion reaction, is a life-threatening reaction to receiving a blood transfusion. AHTRs occur within 24 hours of the transfusion and can be triggered by a few milliliters of blood. The reaction is triggered by host antibodies destroying donor red blood cells.
The red blood cells are removed by macrophages from the blood circulation into liver and spleen to be destroyed, which leads to extravascular haemolysis. This process usually mediated by anti-Rh and anti-Kidd antibodies. However, this type of transfusion reaction is less severe when compared to acute haemolytic transfusion reaction. [36]
If a person without a Kidd blood antigen (for example a Jka-Jkb+ patient) receives a Kidd antigen (Jka-antigen for example) in a red blood cell transfusion and forms an alloantibody (anti-Jka); upon subsequent transfusion with Jka-antigen positive red blood cells, the patient may have a delayed hemolytic transfusion reaction as their anti-Jka antibody hemolyzes the transfused Jka-antigen ...
Thus, on pre-transfusion testing, an anti-Jka or -Jkb may go undetected. Following transfusion, a subsequent robust antibody response in the patient can occur (anamnestic response), resulting in hemolysis of the transfused red blood cells. Kidd antibodies are often capable of binding complement and causing intravascular hemolysis.
Transfusion hemosiderosis; Transfusion-associated circulatory overload; Transfusion-associated graft-versus-host disease; Transfusion-dependent anemia; Transfusion-related acute lung injury; Transfusion-related immunomodulation
Febrile non-hemolytic transfusion reaction (FNHTR) is the most common type of transfusion reaction. It is a benign occurrence with symptoms that include fever but not directly related with hemolysis. [1] It is caused by cytokine release from leukocytes within the donor product as a consequence of white blood cell breakdown.
It is often confused with transfusion-related acute lung injury (TRALI), another transfusion reaction. The difference between TACO and TRALI is that TRALI only results in symptoms of respiratory distress while TACO can present with either signs of respiratory distress, peripheral leg swelling, or both. [4]
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