Two Unusual Transfusion Reactions

Abstract

AbstractTwo recent transfusion reactions are reported because of unusual features and the serious nature of the reactions. The cases illustrate how transfusion accidents occur in spite of high standards in the laboratory. The first case was that of a young woman who was inadvertently given a transfusion of ABO incompatible blood after a successful gastrectomy operation. In spite of the subsequent transfusion of a large volume of compatible blood the patient remained collapsed. Intra-abdominal haemorrhage was suspected and proved. It was shown that the haemorrhage state was associated with afibrinogenaemia but in spite of the administration of fibrinogen the patient died. It is considered that the cause of death was irreversible shock following a haemolytic transfusion reaction and the development of afibrinogen¬aemia.The second case was that of a young child with extensive burns. The initial shock had been controlled by transfusion and few days later the child was given compatible blood for anaemia. Mechanical difficulty was encountered in giving the blood and at the end of 18 hours the first bottle of blood (540 ml) was still being administered. At that stage the child had a convulsion and the temperature rose the 105° F (40.5° C). The transfusion was discontinued. Investigation showed that the blood remaining in the bottle was heavily contaminated with B. anthacoides. The patient improved on antibiotic therapy, but died a few days later from renal failure.