Lesson of the week: Incompatible plasma transfusions and haemolysis in children

Blood group compatibility must be observed when transfusing plasma or platelets to children to avoid haemolysis Clinici ans are aware of the hazards of transfusing incompatible red cells, which can lead to fatal haemolytic transfusion reactions as a result of the patient's red cell antibodies reacting with the donor's red cell antigens. Different considerations have to be given to the transfusion of plasma and platelets, which do not contain red cell antigens but do contain donors' ABO group antibodies. Plasma from group O donors contains both A and B antibodies and is therefore potentially incompatible for groups A, B, and AB patients. Immune haemolysis of a patient's red cells may result from the use of plasma or platelets that are not identical for ABO, and this can cause morbidity and complicate recovery and investigation. We report three cases of delayed haemolytic transfusion reactions resulting from the infusion of group O platelets or plasma to patients of group A or AB. Case1— A 5week old baby boy had cardiac surgery. His blood group was A RhD positive. During surgery A RhD positive red cells and fresh frozen plasma were transfused with group …