SOME UNUSUAL OBSERVATIONS IN POST TRANSFUSION REACTIONS: TWO CASES WITH AUTOPSY FINDINGS

Abstract

One patient received 250 cc. of blood and died in a matter of hrs. The other patient received 150 cc. of incompatible blood and lived longer than one week. Both died of the effects of intravascular hemolysis. The clinical and autopsy findings were similar. Both cases demonstrated severe generalized visceral edema with changes in the parenchyma of several vital organs. The hearts, kidneys and livers were especially involved. These findings as well as the clinical pictures permit the diagnosis of hepatorenal syndrome secondary to post blood transfusion hemolysis. The tissue edema observed in these cases appears to be due to the effects of products of split proteins which probably alter the capillary permeability. The edema gives rise to variable degrees of tissue anoxia and consequently parenchymal damage. The findings in these cases suggest that early treatment should take into account the prevention of edema by maintaining the plasma level, withholding intraven. isotonic and hypotonic solns., and promoting diuresis.