Nonimmune hemolytic transfusion reaction

Transfusion medicine
Transfusion reaction
Nonimmune hemolytic transfusion reaction

Author: Huy Phu Pham, M.D., M.P.H.

Topic Completed: 1 September 2011

Revised: 5 April 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Nonimmune hemolytic transfusion reaction

Page views in 2019: 161

Page views in 2020 to date: 46

Table of Contents

Definition / general | Clinical features | Laboratory | Case reports

Cite this page: Pham HP Nonimmune hemolytic transfusion reaction. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/transfusionmednonimmunehemolysis.html. Accessed March 31st, 2020.

Definition / general

Hemolysis of pRBCs from nonimmune causes, such as storage or inappropriate handling of blood products (microwave, using small needle for transfusion, transfusion of pRBCs with lactated Ringer solution, use of hyper or hypo-osmotic fluids, thermal injury, etc.)
ALWAYS need to rule out immune causes of hemolysis
Lysed red cells may cause hemodynamic, renal and pulmonary problems, possibly death

Clinical features

Clinical features and treatment are similar to acute hemolytic transfusion reaction
Stop transfusion and maintain IV access
Contact transfusion service to rule out immune cause of hemolysis
Monitor urine output
Should also consider possibility of transfusion related infection (malaria, babesiosis)

Laboratory

Hemoglobinemia, hemoglobinuria, possibly hyperkalemia (if renal failure)

Case reports

Percutaneous mechanical thrombectomy (Transfusion 2005;45:1291)