Suspected Hemolytic Transfusion Reaction Evaluation

Specialty Compatibility Testing
Indications If a patient experiences unexplained fever or change in vital signs or symptoms such as chest pain, shortness of breath, back pain, diaphoresis, red urine, or unexplained bleeding, the transfusion should be discontinued immediately, and a hemolytic transfusion reaction evaluation should be initiated. Acute hemolytic transfusion reactions, although rare (frequency ~1 in 20,000 transfusions) can be associated with life-threatening complications (intravascular hemolysis, renal failure, disseminated intravascular coagulation (DIC)).

Delayed hemolytic transfusion reaction should be suspected if a patient develops fever, falling hematocrit, and/or hyperbilirubinemia approximately 3 to 7 days following a blood transfusion. These reactions are generally caused by IgG non-complement fixing red blood cell alloantibodies (e.g., anti-D, -c, -E, -K, -Fya, or -Jka).
Test Information The initial hemolytic transfusion reaction evaluation consists of a clerical check to verify proper patient and unit identification, a visual check of patient plasma for hemolysis, and a direct antiglobulin test. If the direct antiglobulin test is positive and/or the patient’s plasma is hemolyzed, an extended serologic evaluation will be performed.
Sample Requirements EDTA
Requested Volume 7 ml
Minimum Volume or Pediatric vol 1-5 years old, 3 ml EDTA;
< 1 year old, 2 full 0.5 ml EDTA microtainers
Requisition Form Report of Suspected Hemolytic Transfusion Reaction 
Transaction Code 3148-00
CPT Codes 86078
Test Schedule Monday-Sunday
Turn around Time (analytic time) Initial evaluation – 10 minutes.
Extended evaluation – may require up to several hours.
Report/ Results Negative