Delayed hemolytic transfusion reaction

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Background

  • Antibody-mediated destruction of the transfused red blood cells
  • Occurs 2 or more days after transfusion
  • Occurs in 1 in 7000 transfusions

Clinical Manifestations

  • Onset 3 days to 2 weeks after transfusion
  • Fever and jaundice

Investigations

  • Unexpected drop in hemoglobin
  • High bilirubin, reticulocyte count, spherocytosis, high LDH
  • Positive antibody screen and positive DAT

Management

  • Supportive care