Precautions surrounding blood transfusion in autoimmune haemolytic XXXX are overestimated.

@entity1 @entity190 @entity417
BACKGROUND: It is very evident that many precautions are taken regarding transfusion of red blood cells in @entity1 with autoimmune haemolytic @entity417 . Frequently, considerable efforts are made to examine the indication and serological compatibility prior to transfusion in such @entity1 . However, at times, this may unnecessarily jeopardize @entity1 who urgently require a red blood cell transfusion. MATERIALS AND METHODS: Thirty-six @entity1 with warm-type autoimmune haemolytic @entity417 were included in this study. All @entity1 had reactive serum autoantibodies and required blood transfusion. Standard serological assays were employed for the detection and characterization of antibodies to red blood cells. RESULTS: A positive direct antiglobulin test was observed in all 36 @entity1 , in addition to detectable antibodies in both the eluate and serum. Significant alloantibodies were detected in the serum samples of three patients (anti-c, anti-JK(a), and anti-E). In 32 @entity1 , red blood cell transfusion was administered with no significant haemolytic transfusion reactions due to auto- and/or allo-antibodies. Due to overestimation of positive cross-matches three @entity1 received no transfusion or delayed transfusion and died, and one @entity1 died due to unrecognised @entity190 and @entity417 which was attributed to an ineffective red blood cell transfusion. DISCUSSION: Many of the reported recommendations regarding transfusion of red blood cells in autoimmune haemolytic @entity417 are highly questionable, and positive serological cross-matches should not result in a delay or refusal of necessary blood transfusions.
