Delayed Hemolytic: 3days to several months. S/S: fever, jaundice, and decreased hemoglobin. Generally, no management necessary. If hemolysis is severe enough, further transfusions may be needed.
Hep. B: Usually resolves 4-6 weeks. S/S: elevated AST and ALT, anorexia, malaise, N&V, fever, dark urine, and jaundice. Treat symptomatically.
Hep. C: Symptoms less severe than Hepatitis B.Only symptoms are treated.
Iron overload:Heart failure, dysrhythmias, impaired thyroid function, diabetes, arthritis, and cirrhosis. IM or IV deferoxamine (Desferal). Oral agents: deferasirox (Exjade), and deferiprone (Ferriprox)
The most common signs are a falling hematocrit (due to extravascular destruction of the transfused red blood cells) and a positive direct antiglobulin (Coombs) test (DAT).
"Delayed" hemolytic reactions commonly occurs about 4-8 days after blood transfusion, but may develop up to one month later. There may also be hemoglobinuria and a mild elevation of the serum bilirubin. . Symptomatic patients may manifest fever and leukocytosis thus appearing to have an occult infection.
Many delayed hemolytic reactions will go undetected because the red cell destruction occurs slowly
Delayed hemolytic reactions occur in patients who have developed antibodies from previous transfusion or pregnancy but, at the time of pretransfusion testing, the antibody in question is too weak to be detected by standard procedures. Subsequent transfusion with red cells having the corresponding antigen results in an anamnestic antibody response and hemolysis of transfused red cells.