A case report of heterogeneous blood transfusion in the operating room

Introduction: Mismatched-blood transfusions in the ABO-system may lead to severe of complications such as intravascular hemolysis. Case report: A 49-year-old man suffering from a right lower limb injury due to accident was admitted to hospital. Vital signs were normal. X-ray showed a femoral neck fracture. Before surgery, all of lab tests were in normal values and B+ blood- group was reported. During surgery and due to blood loss, the patient underwent blood transfusion. At the end of transfusion, a mismatched blood bag was observed. The patient had received about 400 cc mismatched-blood. Transfusion was promptly terminated and the patient received extensive IV fluids in addition to a single dose of furosemide. The patient had stable status without signs of overt hemolysis. After 3 days stay at intensive care unit, he was transferred to the ward with a stable status. Conclusion: In spite of mismatched blood transfusion, the patient did not experience severe adverse events. To prevent this problem, different steps of blood transfusion should be checked by anesthesiologist