Investigation - Acute Non-Immune Hemolytic Transfusion Reactions

For an acute non-immune HTR the investigation does not reveal serologic abnormalities or misidentification errors but rather, in most cases, a handling, storage, or transfusion error or malfunction that results in physical or chemical destruction of red cells.

Non-immune hemolytic transfusion reactions should be suspected in the presence of unexplained hemoglobinuria that is temporally related to red cell transfusion but not associated with other signs and symptoms of an acute hemolytic transfusion reaction.

Transfusion services should have clear policies describing the required investigations for transfusion complications.  An example of an immediate investigation shows steps that could be used to investigate any immediate transfusion reaction.