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Case Studies | Anaesthesiology | India | Volume 14 Issue 3, March 2025 | Popularity: 4.8 / 10
Delayed Hemolytic Transfusion Reaction in a Post Operative Patient
Dr. B. Ishwarya, Dr. Prasad Kulkarni, Dr. Uthkala B Hegde, Dr. B. Kishore Kumar Reddy
Abstract: The occurrence of jaundice in postoperative patients, as illustrated by this case of a 44 - year - old woman undergoing total abdominal hysterectomy with bilateral salpingo - oophorectomy, underscores a critical yet often overlooked complication tied to surgical interventions. This patient, initially presenting with abnormal uterine bleeding and a suspected uterine mass, experienced an uneventful surgery but developed icterus, hematuria, and malaise a day later symptoms that pointed to a delayed hemolytic transfusion reaction (DHTR) following a single unit of packed red blood cells transfused intraoperatively. It is evident that the interplay of surgical stress and transfusion - related immune responses can precipitate such rare events, with laboratory findings like elevated bilirubin and a positive direct antiglobulin test confirming hemolysis driven by newly formed alloantibodies. This suggests that while DHTR remains uncommon, its subtle onset demands heightened clinical vigilance, especially in the postoperative window. Taking this further, the case reveals gaps in routine pretransfusion protocols and advocates for enhanced screening practices, such as extended antigen typing, to curb alloimmunization risks. Managed conservatively with hydration and monitoring, the patient recovered, but her experience serves as a compelling reminder of the need for prompt recognition and tailored care to safeguard outcomes in similar scenarios.
Keywords: Delayed hemolytic transfusion reaction, postoperative jaundice, total abdominal hysterectomy, alloimmunization, blood transfusion complications
Edition: Volume 14 Issue 3, March 2025
Pages: 1130 - 1131
DOI: https://www.doi.org/10.21275/SR25319222605
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