Question

What test will you perform if adult patients being cross matched have received RBC transfusions in the previous two weeks and who have a positive DAT due to IgG?

Answer 1

Finally I would like to advise that these goals can be achieved by taking the consideration of proper plan.

Blood transfusion can be life-saving and provides great clinical benefit to many patients but it is not without risks, as there are chances of:

·         Immunological complications.

• Infections (bacterial, viral, possibly prion).
• Immunomodulation.
• Litigation.

                                 

The major cause of this issue is acute hemolytic transfusion reactions.

In this case if adult patients being cross matched have received RBC transfusions in the previous two weeks and who have a positive DAT due to IgG, this is the case of delayed hemolytic transfusion reaction.

In this case anamnestic antibody is identified serologically.

At post-PLT transfusion direct antiglobulin test (DAT) there is presence of IgG this is very serious putting the patient at risk for recurrent problems.

In this case there is decrease in hemoglobin level helps the clinician to make the diagnosis.

If a delayed hemolytic reaction is suspected, blood should be sent to the blood bank for testing. Often the antibodies to these minor antigens will subside again.

In this case we should go for the management of the situation in following way:

Blood should be sent for testing.

Treatment is infrequently obligatory. Urine output & renal function should be monitored. Transfusion of antigen negative blood may be necessary for treatment of anemia.

The responsible antibody should be acknowledged & all supplementary units must be negative for the subsequent antigen.

When RBC antibodies are recognized, patients should be educated & advised to give this in order when they are hospitalized somewhere else.

Carrying a transfusion alert card is recommended in this case.

Physicians whose patients tell them about previously identified antibodies should instantly notify the Transfusion examination.

In this way we can handle the above mentioned case.