Acute Hemolytic Transfusion Reaction

An acute hemolytic transfusion reaction is a serious complication of blood transfusion in which the recipient immune system rapidly destroys the transfused red blood cells, most often because of ABO blood group incompatibility caused by a clerical or identification error. It typically begins within minutes to hours of the transfusion and can cause fever, chills, back or chest pain, low blood pressure, and dark urine from the breakdown products of the destroyed red cells, and in severe cases it can lead to kidney failure, shock and disseminated intravascular coagulation. Because ABO-incompatible reactions are largely preventable, strict verification of patient identity and blood type at every step of the transfusion process is the main safeguard. Treatment on suspicion of a reaction involves immediately stopping the transfusion and providing supportive care, including intravenous fluids and monitoring of kidney function.