Febrile nonhemolytic transfusion reactions. Management by premedication and cost implications in adult patients.

Context: Febrile nonhemolytic transfusion reactions (FNHTRs) cause unwelcome interruptions during the course of blood product transfusions and necessitate measures to verify the nature of the reaction and to exclude certain dangerous reactions, such as hemolytic and septic phenomena.

Objective: To examine transfusion medicine data to determine the clinical implications of the routine administration of antipyretic medication to adult patients before transfusion for the prevention of FNHTRs.

Design: A retrospective review was conducted of FNHTR data during 5 years (1998-2002), and a determination was made of the cost of a transfusion complicated by an FNHTR.

Association of renal graft survival with matching at the HLA-DR locus.

The influence of HLA-DR antigen matching in 70 cadaver transplants was studied for up to four years. The overall cumulative renal graft survival at one year was 62 percent, and at two and four years it was 60 percent. The one, two, and four year cumulative graft survival for patients receiving one or two HLA-DR antigen matched grafts was 74 percent, 69 percent, and 69 percent, respectively.

Analysis of paternity. The use of HLA and red cell antigens.

Over a 6-year period, 866 cases were analyzed for disputed parentage. In 194 cases (22%), the alleged father was excluded as the biological father. One hundred and eight-one cases (93%) were direct exclusions, and 13 cases (7%) were indirect exclusions.

Auto-anti-A1 antibody in a patient with metastatic adenocarcinoma.

An autoantibody was found on the red cells of a patient who had never been transfused previously, but was ill with metastatic adenocarcinoma. The patient's blood group was A1. In addition, the patient's serum and the eluate from the patient's red cells agglutinated A1 but not A2, B, and O red cells.