An interdisciplinary team has been commissioned to create policies and procedures aimed at preventing acute hemolytic transfusion reactions. What action has the greatest potential to reduce the risk of this transfusion reaction?

Answer: Compatibility test and double check of the blood bags before the transfusion.

Explanation: To minimize the risks of adverse reactions during a transfusion, health professionals should be careful by performing the compatibility analysis of donor and recipient blood.

The routine of the erythrocytes compatibility tests include four steps: ABO e RhD factor classification, screening of IgG antibodies against other erythrocyte antigens (except ABO) and, for the last, cross-proof. This tests can be done about 45 a 60 minutes.

In these tests, the presence of ABO, RhD and other antibodies such as Kell, Kidd, Duffy is verified. Red blood cells should be ABO-compatible to avoid intravascular hemolysis. RhD-negative patients should receive RhD-negative red blood cells to prevent anti-D alloimmunization. Anti-Rh, Kell, Kidd, Duffy antibodies can also hemolyze transfused red blood cells. Both donor and reciever should be tested for the cited antibodies.

Beyond the strictly scientific part described above, the most important action to reduce the risks of a transfusion reaction is to make sure that have been done a double verification of the hang tags contained in each one blood bags, before the transfusion, to guarantee that the units are intended to that receiver. The health professional should manage the blood slowly, one blood bag in every 4 hours, considering that the adverse reactions appears during the first fifteen minutes.