How are delayed hemolytic transfusions reactions (DHTR) treated?

Updated: Sep 08, 2017
  • Author: Douglas Blackall, MD, MPH; Chief Editor: Michael A Kaliner, MD  more...
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Answer

Most patients tolerate DHTRs well and only require observation and supportive care.

Good communication with the blood bank is essential to provide future transfusion support with antigen-negative RBCs. If these RBCs are not available, weigh the risk of further hemolysis against the indications for transfusion.

If the load of transfused antigen-positive packed RBCs is large (>5 U), exchange transfusion should be considered. In addition, the administration of intravenous human immunoglobulin (IVIG) to block further hemolysis is worth consideration. The IVIG dose is 400 mg/kg, infused slowly, within 24 hours of transfusion.


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