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Delayed Serologic Transfusion Reaction

A delayed serologic transfusion reaction (DSTR) occurs when a recipient develops new antibodies against red blood cells between 24 hours and 28 days after a transfusion without exhibiting any clinical symptoms or laboratory evidence of hemolysis. The frequency of DSTR during a 12 year interval at the Mayo Clinic was 1 case per 2990 units red blood cells tranfused.

The National Healthcare Safety Network (NHSN) hemovigilance protocol defines DSTR as the absence of clinical signs of hemolysis AND demonstration of new, clinically significant antibodies against red blood cells BY EITHER positive direct antiglobulin test (DAT) OR positive antibody screen with newly identified RBC alloantibody.

DSTR must be distinguished from a delayed hemolytic transfusion reaction, in which there is evidence of hemolysis such as an inadequate rise of post-transfusion hemoglobin level or a rapid fall in hemoglobin back to the pre-transfusion level.

Ness PM, et al. The differentiation of delayed serologic and delayed hemolytic transfusion reactions: incidence, long-term serologic findings, and clinical significance. Transfusion.1990 Oct;30(8):688-93.

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