Extravascular hemolytic transfusion reaction - Revision history

Danbot: Expand: DHTR mechanism, Kidd/Rh/Duffy antibodies, evaluation, blood bank notification

2026-03-21T01:43:51Z

Expand: DHTR mechanism, Kidd/Rh/Duffy antibodies, evaluation, blood bank notification

← Older revision		Revision as of 01:43, 21 March 2026
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	==Background==		==Background==
	*Occurs days ~~to weeks~~ after transfusion		*Delayed immune-mediated destruction of transfused RBCs by recipient antibodies (IgG)
			*Occurs '''2-10 days''' after transfusion (delayed hemolytic transfusion reaction, DHTR)
			*Caused by anamnestic antibody response: recipient was previously sensitized (prior transfusion, pregnancy) but antibody titer fell below detection at time of crossmatch
			*Hemolysis occurs extravascularly in the spleen, liver, and bone marrow (reticuloendothelial system)
			*Most common clinically significant antibodies: Kidd (Jk), Rh, Duffy (Fy), Kell

	==Clinical Features==		==Clinical Features==
	*[[hemolytic ~~anemia~~\|~~Hemolysis~~]] ~~occurs in spleen, liver, and bone marrow~~		*Often subclinical or mild
			*Unexplained drop in hemoglobin or failure of expected post-transfusion hemoglobin rise
			*Low-grade [[fever]]
			*Mild [[jaundice]] (indirect [[hyperbilirubinemia]])
			*Dark urine (less common than in [[intravascular hemolytic transfusion reaction\|intravascular hemolysis]])
			*Rarely progresses to clinically significant hemolysis

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*~~[[Hyperbilirubinemia]]~~		*Positive direct antiglobulin test (DAT/Coombs)
	*~~Poor response to~~ transfusion		*Elevated indirect bilirubin, LDH
			*Decreased haptoglobin
			*Positive antibody screen with new alloantibody identified
			*Inadequate hemoglobin rise after transfusion
			*Reticulocytosis

	==Management==		==Management==
	*~~None necessary~~; ~~rarely fatal~~		*'''Rarely requires specific treatment''' — usually self-limited
			*Notify blood bank immediately for antibody identification
			*Future transfusions must be antigen-negative for the identified antibody
			*Supportive care; transfuse if clinically indicated (with antigen-negative units)
			*Monitor for rare progression to severe hemolysis

	==Disposition==		==Disposition==
			*May not require admission if hemodynamically stable and hemolysis is mild
			*Ensure blood bank notification and updated antibody record

	==See Also==		==See Also==
	{{Transfusion reactions see also}}		{{Transfusion reactions see also}}

	~~==External Links==~~


	==References==		==References==

ClaireLewis at 00:28, 1 October 2019

2019-10-01T00:28:58Z

← Older revision		Revision as of 00:28, 1 October 2019
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	==Clinical Features==		==Clinical Features==
	*Hemolysis occurs in spleen, liver, and bone marrow		*[[hemolytic anemia\|Hemolysis]] occurs in spleen, liver, and bone marrow

	==Differential Diagnosis==		==Differential Diagnosis==

Mholtz at 06:33, 13 July 2017

2017-07-13T06:33:09Z

← Older revision		Revision as of 06:33, 13 July 2017
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	==Disposition==		==Disposition==


	==See Also==		==See Also==
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	==External Links==		==External Links==


	==References==		==References==

	<references/>		<references/>

	[[Category:Heme/Onc]]		[[Category:Heme/Onc]]

ClaireLewis: Created page with "==Background== Occurs days to weeks after transfusion ==Clinical Features== Hemolysis occurs in spleen, liver, and bone marrow ==Differential Diagnosis== {{Transfusion rea..."

2017-04-03T16:50:16Z

Created page with "==Background== *Occurs days to weeks after transfusion ==Clinical Features== *Hemolysis occurs in spleen, liver, and bone marrow ==Differential Diagnosis== {{Transfusion rea..."

New page

==Background==
*Occurs days to weeks after transfusion

==Clinical Features==
*Hemolysis occurs in spleen, liver, and bone marrow

==Differential Diagnosis==
{{Transfusion reaction types}}

==Evaluation==
*[[Hyperbilirubinemia]]
*Poor response to transfusion

==Management==
*None necessary; rarely fatal

==Disposition==

==See Also==
{{Transfusion reactions see also}}

==External Links==

==References==

<references/>

[[Category:Heme/Onc]]

Extravascular hemolytic transfusion reaction - Revision history

Danbot: Expand: DHTR mechanism, Kidd/Rh/Duffy antibodies, evaluation, blood bank notification

ClaireLewis at 00:28, 1 October 2019

Mholtz at 06:33, 13 July 2017

ClaireLewis: Created page with "==Background== *Occurs days to weeks after transfusion ==Clinical Features== *Hemolysis occurs in spleen, liver, and bone marrow ==Differential Diagnosis== {{Transfusion rea..."

ClaireLewis: Created page with "==Background== Occurs days to weeks after transfusion ==Clinical Features== Hemolysis occurs in spleen, liver, and bone marrow ==Differential Diagnosis== {{Transfusion rea..."