- Transaction Code: 3148-00
- CPT Code (Suggested): 86078
To order, use Report of Suspected Hemolytic Transfusion Reaction form.
If a patient experiences unexplained fever or change in vital signs or symptoms such as chest pain, shortness of breath, back pain, diaphoresis, red urine, or unexplained bleeding, the transfusion should be discontinued immediately, and a hemolytic transfusion reaction evaluation should be initiated. Acute hemolytic transfusion reactions, although rare (frequency ~1 in 20,000 transfusions) can be associated with life-threatening complications (intravascular hemolysis, renal failure, disseminated intravascular coagulation (DIC)). These reactions are usually caused by complement-fixing ABO hemagglutinins due to incompatibility between donor and recipient usually as a result of a clerical error.
Delayed hemolytic transfusion reaction should be suspected if a patient develops fever, falling hematocrit, and/or hyperbilirubinemia approximately 3 to 7 days following a blood transfusion. These reactions are generally caused by IgG non-complement fixing red blood cell alloantibodies (e.g., anti-D, -c, -E, -K, -Fya, or -Jka).
The initial hemolytic transfusion reaction evaluation consists of a clerical check to verify proper patient and unit identification, a visual check of patient plasma for hemolysis, and a direct antiglobulin test. If the direct antiglobulin test is positive and/or the patient’s plasma is hemolyzed, an extended serologic evaluation will be performed.
- Normal Test Values: Negative
- Analytic Time: Initial evaluation – 10 minutes. Extended evaluation – may require up to several hours.
- Days Test is Set Up: Monday-Sunday
- Sample Required: > 5 years old, 7 ml EDTA; 1-5 years old, 3 ml EDTA; < 1 year old, 2 full 0.5 ml EDTA microtainers
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