Blood Transfusion in Auto-Immune Haemolytic Anaemia

Auto-immune haemolytic anaemia (AIHA) is an immune disease associated with red cell destruction. Transfusion support may be needed to support the anaemia as a result of haemolysis while steroids and other therapies become effective. Autoantibody which reacts with normal red cells pose challenge to identify a compatible unit for transfusion. Prophylactically phenotype matched units are safe for transfusion, but phenotype of the patient is seldom available. It is essential to evaluate for presence of allo-antibody before transfusion and the masking nature of autoantibody makes it more challenging in its identification. Auto- and allo-adsorption can be used if there is enough time available before the patient needs transfusion. Dilution technique can be handy to provide a red cell unit if there is little or no time available for transfusion. Although, transfusion in a case of AIHA comes with risk of reduced survival of red cells post transfusion, often it can be life-saving.