What is the pathophysiology of delayed hemolytic transfusion reactions (DHTRs)?

Updated: Jan 12, 2021
  • Author: S Gerald Sandler, MD, FCAP, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Approximately 3 months is required for a patient to produce detectable levels of antibody after first exposure to a foreign red blood cell (RBC) antigen through transfusion or pregnancy. If no additional RBC antigen stimulus occurs, the antibody can become undetectable in 50% of patients within 5 years. Following renewed exposure to the same antigen, a more rapid antibody response can occur from 3 to 21 days later. Peak antibody production usually occurs between 7 and 10 days after exposure. Transfused RBCs containing the antigen undergo extravascular hemolysis by the reticuloendothelial system of the spleen and liver over a period of several hours to days.

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