What causes acute hemolytic transfusion reactions?

Updated: Jan 12, 2021
  • Author: S Gerald Sandler, MD, FCAP, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Accidental transfusion of RBCs of a different ABO type than the patient's typically occurs for one of two reasons, as follows:

  • Misidentification of either the patient or the blood component when the blood sample was collected for compatibility testing

  • Failure to recognize that two patients have the same or similar names but different ABO blood types

Most transfusions of incorrect RBCs to the incorrect patient due to misidentification are clinically benign. More than 60% of random units of RBCs in a blood bank are serologically compatible with random recipients because approximately 40% are type O (ie, universal donor) and 20% are the same blood type as the patient or are otherwise ABO-compatible.

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