During emergency treatment for hemorrhagic shock, an acutely injured 15-year-old girl received 3,000 ml of ABO-incompatible blood. Hemolysis, abnormal clotting studies, renal shutdown, and severe hypotension developed rapidly. After being treated with extreme hemodilution, hypothermia, and exchange transfusion, she left the hospital asymptomatic 14 days after admission. To our knowledge, this is the first patient to have survived an acute transfusion reaction following a 3,000-ml transfusion of ABO-incompatible blood.
(JAMA 229:790-792, 1974)