Clinical outcomes of ABO-incompatible RBC transfusions

Kim A. Janatpour, Norman D. Kalmin, Hanne M Jensen, Paul V. Holland

Research output: Contribution to journalArticlepeer-review

67 Scopus citations


Factors that predict outcome after ABO-incompatible RBC transfusions are not well defined. We studied whether the volume of incompatible blood transfused would determine the signs and symptoms and survival outcome for ABO-incompatible RBC transfusions. We reviewed ABO-incompatible RBC transfusions from our institutions and our consultations for 35 years and from a survey of America's Blood Centers'members regarding causes, volume, signs, symptoms, and outcomes of ABO-incompatible RBC transfusions in their service areas from 1995 through 2005. All ABO-incompatible transfusions were due to error; 26 (62%) of 42 occurred at the patient's bedside. Of 36 patients who received more than 50 mL of incompatible blood, 23 (64%) manifested signs or symptoms related to the incompatible transfusion, and 6 (17)% died. Only 3 (25%) of 12 patients who received 50 mL or less of incompatible blood had associated signs or symptoms, and none died. Hypotension, hemoglobinuria, and/or hemoglobinemia were the most frequent findings in survivors and patients who died. ABO-incompatible RBC transfusion does not inevitably mean death or even occurrence of symptoms. Prompt recognition and discontinuation of the transfusion are critical because transfusing less ABO-incompatible blood may minimize signs and symptoms and may prevent death.

Original languageEnglish (US)
Pages (from-to)276-281
Number of pages6
JournalAmerican Journal of Clinical Pathology
Issue number2
StatePublished - Feb 2008


  • ABO
  • ABO incompatible
  • RBCs
  • Transfusion

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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