Hemolysis and Intravascular Coagulation Due to Incompatible Red Cell Transfusion in Isoimmunized Monkeys.
ARMY MEDICAL RESEARCH LAB FORT KNOX KY
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Ten monkeys were selected at random and divided into two groups for convenience in immunization. Each monkey was given an intramuscular injection of a mixture of red cells suspended in complete Freunds adjuvant from the five animals in its group. After 6 weeks a second injection in incomplete Freunds was given. Serial crossmatches were performed at 37C, 4C, and with rabbit antimonkey Coombs serum. All animals developed antibody to red cells from at least one of the five donors, and several against all four nonautologous donors. Antibody concentrations peaked at 3 to 4 weeks after initial injection. Subsequent immunizations produced higher and longer lived titers. Cold agglutinins frequently appeared before warm agglutinins and often decreased in titer as the others rose. Hemolysins were seen frequently. Transfusion reactions between incompatible pairs followed intravenous injections of 10 of recipients red cell masses as 51Cr tagged cells. Major reactions occurred in five of seven animals and consisted of complete destruction of infused cells within 5 minutes hemoglobinuria, hemoglobinemia, oliguria, anuria in one case, and the disseminated intravascular coagulation syndrome in three cases. The remaining two animals had extravascular destruction of the transfused blood and exhibited no coagulation changes. Stroma from red cells disrupted within the circulation probably initiates intravascular coagulation. This response may be conditioned by the functional state of the reticuloendothelial system. Author
- Medicine and Medical Research