Acute hemolytic transfusion reactions—a fresh look at pathogenesis and considerations regarding therapy

Abstract

A review of current knowledge of acute hemolytic transfusion reactions indicates that much was learned in recent years about the pathogenetic mechanisms involved. An approach to effective therapy for patients suffering such reactions should be based on the latest understanding of the pathophysiology of this syndrome. Changes in the therapeutic approach have not kept abreast of increased awareness of the etiologic factors, and the patient is not getting the benefit of increased knowledge in this area. The primary pathogenetic mechanisms involved in these reactions appear to be disseminated intravascular coagulation and a series of hemodynamic alterations leading to ischemic necrosis of tissues. Therapy would best be aimed at interfering with these primary pathophysiologic pathways.