Massive Transfusion Protocol in a 69 Year Old Woman with Alloantibodies

Unlike routine blood transfusions that are managed by attending providers and rely on compatibility testing, massive transfusions are managed by the trauma team members, who usually do not have immediate access to compatibility testing. Incompatible C or E antigens, when present in uncrossmatched O positive blood, require transfusion support so that health care professionals can manage potential causes for extravascular hemolysis. Herein, we describe a massive transfusion situation in which immediate patient management was required to mitigate potentially fatal clinical consequences of transfused red blood cell antibodies. In addition, this case study shows how the utility of chemistry and hematology laboratory results can illustrate the complexities of massive transfusion management in the context of incompatible C or E antigens.