@article {4682,
	title = {Acute haemolysis, DIC and renal failure after transfusion of uncross-matched blood during trauma resuscitation: illustrative case and literature review},
	year = {2018},
	month = {Feb},
	abstract = {AIMS/OBJECTIVES:

The aims of this study were to report a patient with acute haemolytic transfusion reaction (HTR) after transfusing uncross-matched red blood cell (RBC) units and to identify the frequency of this complication.
BACKGROUND:

Uncross-matched RBC units are commonly transfused in emergencies, but the frequency of acute HTR is unknown.
METHODS:

We describe a male stabbing victim who received three units of uncross-matched RBC units complicated by acute intravascular HTR, disseminated intravascular coagulation (DIC) and renal failure. We identified 14 studies evaluating the frequency of acute HTR post-emergency transfusion of uncross-matched RBC units.
RESULTS:

Acute HTR was shown by haemoglobinuria, free-plasma haemoglobin and methemalbumin, with anti-K and anti-Fya eluted from recipient red cells; acute DIC featured severe hypofibrinogenemia, thrombocytopenia, elevated fibrin D-dimer and multiple bilateral renal infarcts. Two of the three transfused units reacted with pre-existing RBC alloantibodies [anti-K (titre, 128), anti-Fya (titre, 512)], explained by transfusion 25 years earlier. Our literature review found the frequency of acute HTR following emergency transfusion of uncross-matched RBC units to be 2/3998 [0{\textperiodcentered}06\% (95\% CI, 0{\textperiodcentered}01-0{\textperiodcentered}21\%)].
CONCLUSIONS:

Although emergency transfusion of uncross-matched blood is commonly practiced at trauma centres worldwide, with low risk of acute HTR (<1/1000), our well-documented patient case demonstrates the potential for acute HTR with severe complications.},
	keywords = {alloimmune haemolytic transfusion reaction, disseminated intravascular coagulation, emergency transfusion, renal failure, uncross-matched blood},
	doi = {10.1111/tme.12513},
	author = {Fiorellino, J and Elahie AL and Warkentin, TE}
}
