Acute hemolytic transfusion reaction (AHTR) is a rare but serious complication of blood transfusion. It occurs when the recipient's immune system attacks the donor red blood cells (RBCs) due to ABO incompatibility or non-ABO incompatibility. Non-ABO incompatibility is less common but can also lead to AHTR.
Non-ABO incompatibility occurs when the recipient has antibodies against antigens on the donor RBCs that are different from the ABO system. These antibodies can be naturally occurring or can develop after previous transfusions or pregnancies. Non-ABO antigens include Rh, Kell, Duffy, Kidd, and others.
The symptoms of AHTR due to non-ABO incompatibility are similar to those of ABO incompatibility and include fever, chills, nausea, vomiting, chest or back pain, hypotension, and kidney failure. The severity of the reaction can vary, from mild to life-threatening.
If AHTR is suspected, the transfusion should be stopped immediately, and the patient should be closely monitored. The patient's blood and urine should be tested for evidence of hemolysis, and supportive care should be provided. In severe cases, the patient may require blood transfusions, dialysis, or other interventions.
In conclusion, AHTR due to non-ABO incompatibility is a rare but serious complication of blood transfusion. Blood banks screen for non-ABO antigens, and patients with known antibodies should receive compatible blood. Patients who have had an AHTR in the past should be educated about the risk of recurrence.