Risk of hemolytic transfusion reactions following emergency-release RBC transfusion

Am J Clin Pathol. 2010 Aug;134(2):202-6. doi: 10.1309/AJCP9OFJN7FLTXDB.


Group O RBCs are typically issued for urgent transfusions to avoid ABO-incompatible hemolytic transfusion reactions (HTRs). Identification of other clinically significant alloantibodies requires an antibody detection test, and emergency release (ER) of RBCs before its completion carries a risk of non-ABO alloantibody-mediated HTRs. We performed a retrospective review of 1,002 ER RBC transfusions involving 265 ER episodes (262 recipients) in a tertiary medical center, 2006-2008, to determine the risk of non-ABO alloantibody-mediated HTRs. A positive antibody detection test was found in 29 (10.9%) of 265 ER episodes, with clinically significant alloantibodies in 17 (6.4%) of 265 ER episodes. Fifteen antigen-incompatible RBC units were transfused to 7 recipients with clinically significant alloantibodies; 1 transfusion was followed by an HTR. Based on our study, transfusion of ER RBCs before completion of routine blood bank testing carries a low risk of non-ABO alloantibody-mediated HTRs (1/265 [0.4% ER episodes]) and receipt of antigen-incompatible RBCs (7/265 [2.6% ER episodes]).

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Group Incompatibility / complications*
  • Child
  • Child, Preschool
  • Emergencies
  • Erythrocyte Transfusion / adverse effects*
  • Female
  • Hemolysis*
  • Humans
  • Infant
  • Infant, Newborn
  • Isoantibodies / blood*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Young Adult


  • Isoantibodies