Delayed Hemolytic Transfusion Reaction (DHTR), anti-S

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Guastafierro: Case Report
Time to detection: 
6 days
Alerting signals, symptoms, evidence of occurrence: 
Following removal of the sigmoid colon, the patient received 3 units of red cells. Six days later, the hemoglobin level decreased and biochemical serum values showed Hb 6.2 g/dL, LDH 975 I.U./L and total bilirubin 2.95 mg/dL (direct 0.35 mg/dL).
Demonstration of imputability or root cause: 
Crossmatches with red cell suspension of transfused blood units and a post-transfusion serum were repeatedly positive. Laboratory tests showed the presence of anti-S alloantobody in the serum and eluate. Moreover, pre-transfusion serum of the patient was retrospectively retested: anti-S was not detected.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest new keywords: 
anti-S; DHTR; crossmatch; LDH; eluate
MNS antibodies
Reference attachment: 
Suggest references: 
Guastafierro, S., Sessa, F., Cuomo, C. and Tirelli, A. (2004). Delayed hemolytic transfusion reaction due to anti-S antibody in patient with anti-Jk(a) autoantibody and multiple alloantibodies. Ann Hematol 83(5):3070308.
Expert comments for publication: 
The antibodies of the MNS system to glycophorin B, anti-S, -s, and -U can all cause immediate and delayed hemolytic transfusion reactions, and anti-U is a particularly dangerous antibody.