The transfusion was immediately stopped after the clinical staff was alerted to the presence of an unexpected antibody, but not before most of the O-negative red blood cells had been transfused.
If the physician had decided to continue transfusing the patient at this stage, the following information should have been communicated:
- Although all donors appear compatible in the post-transfusion crossmatch, they are not.
- The results are false negatives. The patient's antibody has been "mopped up" by adsorbing to the incompatible transfused O Rh-negative red blood cells.
- Given that six donors were positive using the pretransfusion plasma, the antigen is a higher frequency antigen, and most donors would likely be antigen positive and incompatible.
- The patient's physician should consult the transfusion services medical director before transfusing.
- Transfusing red blood cells before tests are complete requires a physician to sign an emergency release form for which the physician assumes full responsibility.
