Acute intravascular hemolysis after transfusion of a chimeric RBC unit

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 2003-10, Vol.43 (10), p.1449-1451
• Main Authors: Pruss, Axel, Heymann, Guido A., Hell, Anette, Kalus, Ulrich J., Krausch, Dietmar, Dörner, Thomas, Kiesewetter, Holger H., Salama, Abdulgabar
• Format: Article
• Language: English
• Subjects: ABO Blood-Group System - immunology; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Chimera - immunology; Erythrocyte Transfusion - adverse effects; Hemolysis; Humans; Male; Medical sciences; Middle Aged; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1046/j.1537-2995.2003.00515.x

BACKGROUND:  Natural blood cell chimerism rarely occurs in humans. The case of a patient who developed transfusion reaction due to the transfusion of chimeric RBCs is reported. CASE REPORT:  A 61‐year‐old male patient with blood group O received two units of packed and O‐grouped RBCs after elective kidney surgery. Immediately after blood transfusion, the patient developed a hemolytic transfusion attack. The serologic re‐examination revealed only a mixed‐field pattern of agglutination of RBCs in one of the two transfused units. The donor of this unit was an apparently healthy 24‐year‐old male with a twin sister. Both of them showed an identical mixture of roughly 95 percent group O and 5 percent group B RBCs by gel agglutination technology and flow cytometry. The results were also confirmed by ABO blood group genotyping. CONCLUSIONS:  This is the first report of a hemolytic transfusion reaction related to the transfusion of chimeric RBCs.