Massive transfusion associated with a hemolytic transfusion reaction: necessary precautions for prevention. Transfusion 2019 Aug;59(8):2532-2535
Date
06/27/2019Pubmed ID
31241167DOI
10.1111/trf.15405Scopus ID
2-s2.0-85068113457 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
CASE REPORT: A 45-year-old male presented in severe hypovolemic shock after a thoracoabdominal gunshot wound. The massive transfusion protocol (MTP) was activated and the patient was taken to the operating room. His major injuries included liver, small bowel, and right common iliac vein. Hemorrhage was stopped and a damage control laparotomy was completed. He received a total of 113 blood products. During his postoperative course he received a group B blood transfusion on Hospital Days 2 and 7 based on incorrect blood typing late in his massive transfusion and repeat testing on Day 4.
RESULTS: He succumbed to multiple organ failure on Day 8. MTPs are standard in most trauma centers during which universal donor red blood cells are initially used. As hemorrhage is controlled, the patient undergoes a complete type and cross according to blood banking protocols. These typing results are used to continue transfusions once the MTP is no longer needed. In contacting other blood banks servicing Level I trauma centers, the policy of when to switch from universal donor blood to crossmatched blood is variable.
CONCLUSION: Our case illustrates a potential blood typing problem that had a disastrous outcome. We identified changes in policy that will make MTPs safer.
Author List
Davis CS, Milia D, Gottschall JL, Weigelt JAAuthors
Christopher Stephen Davis MD, MPH Associate Professor in the Surgery department at Medical College of WisconsinDavid J. Milia MD Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Blood Group IncompatibilityErythrocyte Transfusion
Humans
Male
Middle Aged
Multiple Organ Failure
Shock
Transfusion Reaction
Wounds, Gunshot
