Interdonor Incompatibility as a Cause of Reaction during Granulocyte Transfusion

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Abstract
The 1st case of interdonor incompatibility associated with granulocyte transfusion was presented. The patient received Kell positive granulocyte transfusions containing about 30 ml of red cells 36 and 132 h prior to receiving a granulocyte transfusion containing anti-Kell 1/128. Chills, fever, vomiting and hypotension resulting from the red cell incompatibility cleared with appropriate fluid therapy. Antibody [Ab] detection methods must be applied to each unit of granulocytes. The patient''s blood should be tested with reagent grade Ab to detect small numbers of antigen-containing cells if an Ab-containing granulocyte transfusion is to be given. Routine major and minor cross-matching is insufficient. Removal of the Ab containing plasma and resuspension of the granulocytes in plasma free of irregular Ab may be the most effective way to prevent such incompatibility.