Transfusion medicine
Transfusion reactions
Nonimmune hemolytic

Topic Completed: 1 September 2011

Minor changes: 16 July 2020

Copyright: 2002-2019,, Inc.

PubMed Search: Nonimmune hemolytic transfusion reaction

Huy Phu Pham, M.D., M.P.H.
Page views in 2020: 178
Page views in 2021 to date: 9
Cite this page: Pham HP Nonimmune hemolytic. website. Accessed January 22nd, 2021.
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)
  • Hemoglobinemia, hemoglobinuria, possibly hyperkalemia (if renal failure)
Case reports
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