A 60-year-old man on ICU is being transfused with packed red cells. Thirty minutes into the transfusion, he develops fever (39.2°C from 37.5°C), rigor...

Question

A 60-year-old man on ICU is being transfused with packed red cells. Thirty minutes into the transfusion, he develops fever (39.2°C from 37.5°C), rigors, tachycardia, and back pain. The transfusion is stopped. The team suspects an acute haemolytic transfusion reaction (AHTR). What is the most important immediate laboratory investigation?

Accepted Answer

Direct antiglobulin test (DAT/Coombs test) on a fresh post-transfusion blood sample, along with repeat group and screen, visual inspection of plasma/serum for haemolysis (pink discolouration), urinalysis for haemoglobinuria, and a full blood count - the DAT will be positive if antibody-coated red cells are present

Answer

CRP

Answer

Coagulation screen only

Answer

Blood film for malaria parasites only

Answer

Chest X-ray only

uk-fficm MCQ (SBA): Acute Haemolytic Transfusion Reaction