Delayed Hemolytic Reaction

These reactions are often missed because they may occur days to weeks after the transfusion.  Primary reactions are the development of a new red cell antibody and usually do not lead to red cell destruction.  Secondary reactions occur when the red cell antibody leads to extra vascular removal of red cells. These patients will show a decrease in the hemoglobin over a period of days, but may not demonstrate other signs of reaction.  If hemolysis is brisk, mild symptoms of acute hemolysis may be seen.

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