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Massive transfusion associated with a hemolytic transfusion reaction: necessary precautions for prevention. Transfusion 2019 Aug;59(8):2532-2535



Pubmed ID




Scopus ID

2-s2.0-85068113457 (requires institutional sign-in at Scopus site)   5 Citations


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 JA


Christopher Stephen Davis MD, MPH Associate Professor in the Surgery department at Medical College of Wisconsin
David J. Milia MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Blood Group Incompatibility
Erythrocyte Transfusion
Middle Aged
Multiple Organ Failure
Transfusion Reaction
Wounds, Gunshot