Imperial Collage Healthcare

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Serological investigation of a haemolytic transfusion reaction

Test Background
Haemolytic transfusion reactions are the result of antibodies in a recipient's plasma directed against antigens on transfused red cells. This results in rapid intravascular haemolysis of the donor red blood cells. ABO incompatibility due to clerical error is the most frequent cause and results in haemoglobinaemia, haemoglobinuria, disseminated intravascular coagulation (DIC), renal failure and complement-mediated cardiovascular collapse.

Clinical Indications
Tests to establish if there is any incompatibility between the patient and donor red cells that was not detected on pre-transfusion testing.

Reference Range
Negative (ie. no evidence of transfusion reaction).

Sample Required
EDTA (lavender top)

Sample Volume
2 x 6mL post-transfusion
1 x 6mL pre-transfusion + lines/remnants from units

Turnaround Time
Dependent on clinical requirement. Contact the laboratory to discuss further.

Suspected transfusion reactions should be reported to the hospital transfusion team who will guide appropriate investigation as well as incident reporting.
May be referred to the NHS Blood and Transplant service for confirmation if necessary.

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