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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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Severe DHTR and Sickle Cell Anemia

Sickle cell anemia is a high-risk factor for development of severe DHTR. The reason is that individuals with sickle cell anemia have a high alloimmunization rate.

Treatment requires rapid diagnosis and transfusion support with antigen-negative red cells; however, diagnosis of a DHTR can be difficult because symptoms can be attributed to sickle cell crisis. Delay in medical treatment may lead to death. Therefore, it is essential that the transfusion service has an accurate transfusion history.
The most critical aspect of prevention is for the transfusion service to document all clinically significant antibodies. One challenge in antibody detection is finding a rapid method that is sensitive enough to detect low titers of clinically significant antibodies without being too sensitive for insignificant antibodies. Preventing severe reactions in sickle patients can be done by phenotyping the patients. This is useful in providing phenotypically matched blood and solving complex antibody identification problems.