The Clinical Significance of Warm Autoantibodies during Pregnancy.

Objectives: The objective of the current study is to determine the clinical significance of a warm autoantibody detected in patients during pregnancy.

Background: There are few published studies concerning the clinical significance of warm autoantibodies during pregnancy. The risk to the fetus is determined by the IgG autoantibody's ability to cross the placental barrier.

Anti-E alloimmunization from a platelet apheresis transfusion in a 22-month-old male with acute myeloid leukemia.

RhD alloimmunization from platelet transfusions have been documented in the literature. However, non-RhD platelet alloimmunization is much less frequent and the risk for non-RhD alloimmunization from platelets is thought to be extremely low and most associated with buffy coat pooled platelets. A 22-month-old male with acute myeloid leukemia received 99 mL apheresis platelets for thrombocytopenia.

Preventing transfusion-associated circulatory overload in acute care settings.

Transfusion-associated circulatory overload (TACO) is a potentially life-threatening complication that can occur with the transfusion of any blood component, and accounts for up to 24% of transfusion-associated patient fatalities. This article discusses how to develop evidence-based continuing education and guideline recommendations that will increase nursing staff awareness of TACO and guide nurses in prevention and prompt intervention.

A comparison between liquid group A plasma and thawed group A plasma for massive transfusion activation in trauma patients.

Background And Objectives: The use of group A thawed 24-h plasma when resuscitating haemorrhagic shock patients has become more common; however, limited data exist on the clinical use of liquid plasma (LP). Our aim is to determine whether LP is of clinical benefit to patients requiring massive transfusion.

Materials And Methods: The objective of this retrospective study was to detect any difference in 24-h survival between patients receiving liquid or thawed plasma (TP) during their massive transfusion activation.

Anti-S Antibody: A Rare Cause of Fetal Hydrops in a Previously Sensitized Mother.

Anti-S is an IgG antibody and a rare cause of hemolytic disease of the fetus and newborn. A 38 year old woman with blood group O Rh-positive presented to the hospital at 30 weeks gestation. Her past medical history was significant for sickle cell disease and alloantibodies against the Fya, Jkb, and S antigens.

Fatal sepsis associated with a storage container leak permitting platelet contamination with environmental bacteria after pathogen reduction.

Background: Pathogen reduction technology and enhanced bacterial culture screening promise to significantly reduce the risk of transfusion-associated septic reactions due to contaminated platelets. Recent reports suggest that these interventions lack efficacy for post-collection and processing contamination with environmental organisms if the storage bag integrity is compromised.

Case Report: We report a fatal septic transfusion reaction in a 63-year-old patient with chronic kidney and liver disease who received a pathogen reduced platelet transfusion in anticipation of surgery.

A comparison between leukocyte reduced low titer whole blood vs non-leukocyte reduced low titer whole blood for massive transfusion activation.

Background: Hemorrhagic shock is the leading cause of survivable death in trauma patients and recent literature has focused on resuscitation strategies including transfusing low-titer group O whole blood (LTOWB). Debate remains regarding whether leukocyte reduced (LR) whole blood is of clinical benefit or detriment to patients requiring massive transfusion. This study compares survival outcomes between LR-LTOWB and non-LR LTOWB.

Anti-M-Induced Delayed Hemolytic Transfusion Reaction.

Background: Anti-M is most often assumed to be naturally occurring and can be comprised of a mixture of predominantly immunoglobulin(Ig)M with a lesser IgG component. Anti-M-antibodies usually do not react at 37°C and therefore are considered to be of little clinical significance.

Methods: A 28-year-old man presented with hemorrhagic shock from numerous injuries sustained in a motor vehicle collision.

Implementation of a new blood cooler insert and tracking technology with educational initiatives and its effect on reducing red blood cell wastage.

Background: The objective was to report a successful implementation of a blood cooler insert and tracking technology with educational initiatives and its effect on reducing red blood cell (RBC) wastage.

Study Design And Methods: The blood bank database was used to quantify and categorize total RBC units issued in blood coolers from January 2010 to December 2015 with and without the new inserts throughout the hospital. Radiofrequency identification tags were used with special software to monitor blood cooler tracking.

Successful ABO-Incompatible Renal Transplantation: Blood Group A1B Donor Into A2B Recipient With Anti-A1 Isoagglutinins.

Objectives: Transplantation of the blood group A2B in a recipient was successfully performed in the setting of receiving a deceased donor kidney from an "incompatible" A1B donor.

Methods: The donor and recipient were both typed for ABO blood group, including ABO genotyping. The donor and recipient were tested for ABO, non-ABO, and human leukocyte antigen (HLA) antibodies.

Discriminating complement-mediated acute transfusion reaction for type O+ red blood cells transfused into a B+ recipient with the complement hemolysis using human erythrocytes (CHUHE) assay.

Background: A patient with B+ sickle cell disease received 3 units of red blood cells (RBCs) from two O+ donors and developed fever and hypotension after the first unit, consistent with an acute transfusion reaction (ATR). Anti-B titers in plasma from each O+ donor were markedly elevated and nondiscriminatory. In order to evaluate the potential for the transfused units to produce complement-mediated hemolysis of B+ RBCs, hemolytic complement testing was performed.

Fatal autoimmune hemolytic anemia due to immunoglobulin g autoantibody exacerbated by epstein-barr virus.

Most cases of autoimmune hemolytic anemia (AIHA) are caused by the production of an autoantibody that targets determinants on red blood cells (RBCs). This autoantibody can be immunoglobulin (Ig) G, IgM, or IgA. Some autoantibodies react optimally at 0° to 4°C (ie, cold agglutinin) and usually are clinically insignificant.

Successful unintentional ABO-incompatible renal transplantation: Blood group A1B donor into an A2B recipient.

Objectives: To report a successful unintentional transplantation of a deceased donor kidney from an "incompatible" A1B donor into a recipient who was blood group A2B with unsuspected preformed anti-A1 antibodies.

Methods: The donor and recipient were both typed for ABO antigens. The recipient was tested for ABO and non-ABO antibodies.

The transfusion of neutrophil-specific antibodies causes leukopenia and a broad spectrum of pulmonary reactions.

Background: Antibodies to neutrophil-specific antigens are the best characterized cause of transfusion-related acute lung injury (TRALI).

Case Report: A double-apheresis platelet (PLT) component was divided and transfused into two patients. One experienced chills, rigors, and dyspnea and the other experienced chills and headache.

Black thyroid revisited: cytologic diagnosis in fine-needle aspirates is unlikely.

We report four patients diagnosed with black discoloration of the thyroid gland at surgery and a fifth patient in which the "black thyroid" was an incidental finding at autopsy. The four patients diagnosed at surgery had prior fine-needle aspirations (FNA), which did not reveal any characteristic pigmentation. One patient presented with cervical lymph node metastases from a papillary microcarcinoma of thyroid.