A CLINICAL STUDY OF TRANSFUSION REACTIONS: THE HEMOLYTIC EFFECT OF GROUP-O BLOOD AND POOLED PLASMA CONTAINING INCOMPATIBLE ISOAGGLUTININS

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Abstract
Studies were made in the course of over 350 pooled plasma and Group-O whole blood transfusions, in which patients belonging to blood group A or B received varying concns. of incompatible anti-A and anti-B isoagglutinins. The incidence of febrile hemolytic transfusion reactions was low, approx. 1%, and their severity usually mild. Asymptomatic blood destruction of appreciable degree, however, could frequently be demonstrated by means of serial Ashby counts and measurements of the blood vol. This complication commonly followed the injn. of incompatible isoagglutinins in high titer, or resulted from multiple injns. of these isoantibodies. Manifestations of the hemolytic process, so produced, included the appearance of transient hemoglobi-nemia and hyperbilirubinemia, occasional hemoglobinuria, and a persistent increase in the osmotic fragility of the recipients'' erythrocytes. In a few instances, replacement of the patient''s own RBC by donor erythrocytes appeared to be temporarily complete. Although rarely dangerous to life, the hemolytic properties of incompatible isoantibodies restrict the therapeutic value of pooled plasma and group-O blood, with respect to the use of these materials in transfusing group-A and group-B recipients.

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