RENAL INSUFFICIENCY FROM BLOOD TRANSFUSION

Abstract

The transfusion of incompatible blood into man is accompanied with or immediately followed by chills, fever, nausea and vomiting, acute pains in the muscles, dyspnea and a feeling of constriction in the chest. Signs of hemolysis in vivo may occur within a few hours. These include hemoglobinemia, hemoglobinuria and jaundice. If a relatively small amount of blood is hemolyzed, hemoglobinuria and jaundice may not be evident. Drabkin¹ has shown that only about 10 per cent of the hemoglobin that disappears from the blood stream of the dog appears in the urine. The patient may recover with nothing more serious than the loss of the transfused erythrocytes and consequent hemoglobinuria for several days. In some cases, however, the sequelae are more grave. The urinary excretion is immediately diminished, or ceases entirely, and the products of nitrogen metabolism increase rapidly in the blood. Vomiting continues, and generalized edema sometimes appears. Coma