Investigation of a Delayed Transfusion Reaction

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The page below is a sample from the LabCE course Transfusion Reactions. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Investigation of a Delayed Transfusion Reaction

The appearance of an antibody post-transfusion is a sign of a delayed transfusion reaction. Only when there is evidence of increased red cell destruction is the reaction termed a delayed hemolytic reaction. Appearance of an antibody without cell destruction is a delayed serologic reaction.
    Delayed Reaction Type Testing


    • DAT, eluate if positive
    • Antibody screen

    Alloimmunization to HLA antigens

    • Platelet antibody screen
    • Lymphocytotoxicity testing

    Delayed hemolytic

    • DAT, eluate if positive
    • Antibody screen
    • Other tests for hemolysis

    Transfusion-associated graft-vs-host disease

    • HLA typing
    • Cytogenetic analysis

    Infectious disease transmission

    • Specific testing for antigens or antibodies associated with the disease

    Iron overload

    • Serum ferritin
    • Liver enzymes
    • Endocrine function tests

    Post-transfusion purpura

    • Platelet antibody screen/identification