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Updated: May 18, 2026

Methods for Quantitative Detection of Antibody-induced Complement Activation on Red Blood Cells
Published on: January 29, 2014
Fatal delayed hemolytic transfusion reaction associated with anti-Di(b) and anti-E
Yuichiro Hatano1, Setsuko Otsuka, Mitsuhiro Chousa
1Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan. yuha@gifu-u.ac.jp
Abstract:
We report the death of a 61-year-old Japanese man massively transfused during and after emergency aortic surgery. Postoperative on day 8, he died after cardiac arrest associated with hyperkalemia. Indirect antiglobulin testing demonstrated both anti-Di(b) and anti-E antibodies pre-transfusion, and elevation of their titers as the delayed hemolytic transfusion reaction evolved. Monocyte monolayer assay (induction of reactive monocytes) and flow cytometry (increase of IgG1 and/or IgG3) gave evidence of the clinical significance of both antibodies. Anti-Di(b) must be considered when an antibody to a high incidence antigen is found in Japanese and other Mongoloid populations.
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