Fatal Transfusion Reaction Due to the Kell Factor

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Abstract
A woman of type B, M, Rh1rh was transfused with blood of the same blood groups, but no direct compatibility tests were made. The patient developed a violent hemolytic reaction, became anuric, and subsequently received four compatible transfusions. The clinical course seemed satisfactory but after a week she died suddenly from a cerebrovascular accident. The donor was Kell positive and the patient Kell negative; the donor’s Kell positive cells had disappeared from her blood one day after the transfusion and her serum contained incomplete Kell antibody. The patient’s husband and four children were Kell negative, but she had received twenty-three years previously, five transfusions from four donors. Three of these donors were located, two of whom were Kell positive. In tests of the patient’s serum with one hundred and eighty-two random bloods there were fourteen or 7.7 per cent positive reactions, an incidence which is characteristic of anti-Kell in caucasoids.

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