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SOP

Transfusion Reaction Investigation

SOP for the immediate laboratory investigation of suspected adverse transfusion reactions.

Last verified 1 month ago 1 min read Blood Bank / Transfusion Medicine Laboratory Quality Assurance #blood bank #transfusion reaction #hemolysis #adverse event
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Document Control
Version
1.0
Effective
Aug 28, 2026
Reviewed
Aug 29, 2026
Department
Blood Bank / Transfusion Medicine
Principle

Acute hemolytic transfusion reactions are most often due to ABO incompatibility from clerical errors. Rapid visual and serological checks confirm or rule out in vivo hemolysis.

Standard Operating Procedure: Transfusion Reaction Investigation

1. Purpose: Rapidly identify or rule out hemolytic transfusion reactions and other adverse events.

2. Specimen: Post-transfusion patient blood sample (EDTA and clotted), returned blood bag with giving set.

3. Procedure:

  • Clerical Check: Verify patient ID, blood unit number, and labels on the bag, slip, and patient wristband.
  • Visual Inspection: Check patient plasma/serum for pink/red discoloration (hemolysis). Check returned blood bag for discoloration or clots.
  • Serological Testing: Repeat ABO/Rh on pre- and post-transfusion samples. Perform DAT on post-transfusion sample.
  • Additional: If hemolysis is suspected, check bilirubin, LDH, and haptoglobin.

4. Reporting: Report findings immediately to the attending physician and transfusion service director.

Frequently Asked Questions

Stop the transfusion immediately, keep the IV line open with normal saline, and return the blood bag to the lab.