Fatal delayed hemolytic transfusion reaction associated with anti-Di(b) and anti-E.

TitleFatal delayed hemolytic transfusion reaction associated with anti-Di(b) and anti-E.
Publication TypeJournal Article
Year of Publication2012
AuthorsHatano Y, Otsuka S, Chousa M, Saito S, Nollet KE, Ohto H, Shimabukuro K, Takemura H, Hara A
JournalTransfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis//Transfus Apheresis Sci
Volume47
Issue3
Pagination263 - 8
Date Published2012
ISBN Number1473-0502
Other Numbers101095653
Keywords*Blood Group Incompatibility/bl [Blood], *Erythrocyte Transfusion/mt [Methods], *Rh-Hr Blood-Group System/im [Immunology], Aneurysm, Dissecting/su [Surgery], Antibodies/im [Immunology], Blood Group Incompatibility/im [Immunology], Cardiac Surgical Procedures/mt [Methods], Erythrocyte Transfusion/ae [Adverse Effects], Humans, Isoantibodies/im [Immunology], Male, Middle Aged, Phenotype
Abstract

We report the death of a 61-year-old Japanese man massively transfused during and after emergency aortic surgery. Postoperative on day 8, he died after cardiac arrest associated with hyperkalemia. Indirect antiglobulin testing demonstrated both anti-Di(b) and anti-E antibodies pre-transfusion, and elevation of their titers as the delayed hemolytic transfusion reaction evolved. Monocyte monolayer assay (induction of reactive monocytes) and flow cytometry (increase of IgG1 and/or IgG3) gave evidence of the clinical significance of both antibodies. Anti-Di(b) must be considered when an antibody to a high incidence antigen is found in Japanese and other Mongoloid populations.Copyright © 2012 Elsevier Ltd. All rights reserved.
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