Hemolytic (ABO Mismatch)

Question 1

What is the cause of a Hemolytic (ABO Mismatch) Transfusion reaction?

Answer 1

Recipient antibodies against A and/or B antigens on donor RBCs

This reaction occurs when the recipient’s immune system attacks the transfused red blood cells due to antigen incompatibility.

Question 2

What are the consequences of RBC agglutination in a Hemolytic Transfusion reaction?

Answer 2

Intravascular hemolysis and release of hemoglobin into the bloodstream

Intravascular hemolysis can lead to serious complications, including acute kidney injury due to hemoglobinuria.

Question 3

What additional mechanism can occur due to binding of recipient antibodies to donor RBCs?

Answer 3

Complement activation and lysis of RBCs

Complement activation can enhance the destruction of transfused red blood cells.

Question 4

Which enzyme level can be increased in the setting of hemolysis?

Answer 4

LDH

LDH is released from damaged red blood cells and can be a marker for hemolysis.

Question 5

What symptoms may a patient experience within minutes of a blood transfusion in the case of a Hemolytic reaction?

Answer 5

Fever, chills, and flank pain

These symptoms are indicative of an acute hemolytic transfusion reaction.

Question 6

What might a vignette describe in a patient experiencing a Hemolytic Transfusion reaction?

Answer 6

An ‘impending sense of doom’ after the transfusion is started

This feeling can be a sign of severe distress due to the reaction and is often mentioned in exam questions.

Question 7

What is the next best step after stopping a transfusion due to a suspected Hemolytic reaction?

Answer 7

Antiglobulin test

The antiglobulin test, also known as the Coombs test, is used to detect antibodies against red blood cells.