In addition, every HSCT candidate, as well as the corresponding donor, can have additional conditions leading to HA (eg, glucose-6-phosphate dehydrogenase deficiency). xb```f`` @1V h`f Optimal management of HA after allogeneic HSCT implies an interdisciplinary approach and a close collaboration between clinicians, transfusion service and blood bank and the stem cell laboratory. Laboratory testsmainly serologicalare crucial for the diagnosis of an early haemolytic reaction. In addition, tumour necrosis factor (TNF) and interleukin-1 (IL-1), released by phagocytes during haemolytic transfusion reaction may also contribute to hypotension and shock [32]. Immune hemolytic transfusions reactions occur due to mismatch or incompatibility of Antibodies that cause a delayed haemolytic transfusion reaction are IgG molecules that are binding or non-binding for complementary components. Other causes of HA should be excluded. The presence of these isohemagglutinins and the involvement of the donor's and recipient's immune system are responsible for hemolytic complications (Table 2). The connection of NO with haeme Fe2+ impairs oxygen transport through Hb. Haemolysis may also occur due to non-immunological reasons, such as thermal, osmotic or mechanical damage to the transfused blood; bacterial infection or extremely rare and blood transfusion from a donor with congenital haemolytic anaemia due to deficiency of glucose-6-phosphate dehydrogenase [2]. These include, among others, errors in collecting blood samples from patients and blood transfusions to a wrong patient. Coombs test It should be noted here that the IgM class is more efficient in starting the process of complement activation than the IgG class [2, 15]. Transfusion Reactions Hemolysis in DHTR can be severe, because both the transfused and autologous red blood cells may be destroyed (so-called bystander hemolysis); DHTR /Filter /FlateDecode Attempts have been made to use high doses of intravenous immunoglobulins to prevent haemolytic reactions in patients who have been immunised for winter and for whom compatible red blood cells have not been selected [63].
Thomas Hampson Catherine Pisaroni, Articles H