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Clinical Review Lesson of the week

Incompatible plasma transfusions and haemolysis in children

BMJ 1999; 318 doi: (Published 16 January 1999) Cite this as: BMJ 1999;318:176
  1. J K M Duguida, consultant haematologist,
  2. J Minards, biomedical scientist,b,
  3. P H B Bolton-Maggs, consultant paediatric haematologist.b
  1. aNational Blood Service, Mersey and North Wales Centre, Liverpool L7 8TW,
  2. bAlder Hey Children's Hospital, Liverpool L12 2AP
  1. Correspondence to: Dr J K M Duguid, Department of Haematology, Wrexham Maelor Hospital, Wrexham LL13 7TD
  • Accepted 16 April 1998

Blood group compatibility must be observed when transfusing plasma or platelets to children to avoid haemolysis

Clinici ans are aware of the hazards of transfusing incompatible red cells, which can lead to fatal haemolytic transfusion reactions as a result of the patient's red cell antibodies reacting with the donor's red cell antigens. Different considerations have to be given to the transfusion of plasma and platelets, which do not contain red cell antigens but do contain donors' ABO group antibodies. Plasma from group O donors contains both A and B antibodies and is therefore potentially incompatible for groups A, B, and AB patients. Immune haemolysis of a patient's red cells may result from the use of plasma or platelets that are not identical for ABO, and this can cause morbidity and complicate recovery and investigation. We report three cases of delayed haemolytic transfusion reactions resulting from the infusion of group O platelets or plasma to patients of group A or AB.

Case reports

Case1— A 5week old baby boy had cardiac surgery. His blood group was A RhD positive. During surgery A RhD positive red cells and fresh frozen plasma were transfused with group …

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