Acute Hemolytic Transfusion Reaction due to ABO-Incompatible Blood Transfusion: A Fatal Case Report and Review of the Literature

Abstract

A 77-year-old female patient who was suspected to have had an acute hemolytic transfusion reaction was admitted to the emergency room. She received one unit of type A red blood cells in a type B patient during a total knee arthroplasty operation at another medical institution. ABO-incompatible transfusion was carried out due to an identification error between the patient and blood product. At the time of admission, acute hemolytic reaction, lactic acidosis, and disseminated intravascular coagulation were observed. She was admitted to the intensive care unit and received continuous renal replacement therapy. She maintained renal function and was moved to the general ward on the 7th day. Complications such as pulmonary edema, gastrointestinal bleeding, and ischemic colitis persisted, and the patient died on the 111th after admission. This case is the first report of death due to an ABO-incompatible transfusion in Korea. Efforts to establish a safe transfusion environment are necessary not only at individual medical institutions but also at the national level.

Development of Cryopreserved Red Blood Cell Panels as Biological Reference Standards for Performance Evaluation of ABO and D Blood Grouping Reagents

“…Despite advances in pro ling the molecular genetics of blood groups, a conventional serological grouping method is still widely used as a screening test in transfusion medicine [1][2][3]. As errors in blood grouping may lead to severe complications, such as a hemolytic transfusion reaction, and even death [4], several countries have developed individual standards for the quality assessment of blood grouping reagents to ensure safe and effective transfusion.…”

ABO-Incompatible Transfusion Events Reported in Written Judgments and in the Korean Hemovigilance System

“…Four cases died, 23 cases survived, and the transfusion outcomes of five cases were unknown. All four fatal ABOi transfusion cases were found in written judgments, and case 9 was also found in the 2016 KOHEVIS annual report and the literature [ 7 ]. The types of blood products and errors related with ABOi transfusion are shown in Fig.…”

“…We found 32 ABOi transfusion cases in total-nine in the written judgments (cases 1-9), 16 in the KOHEVIS reports (cases 9-24), and nine in literature published in Korea (cases 9 and 25-32) [7][8][9][10][11][12]. Data of the ABOi transfusion cases reported in Korea are presented in Table 1.…”