Hello All I've just had a patient undergoing an exchange transfusion for sickle cell anemia display symptoms of a transfusion reaction immediately post transfusion of a Diego a positive bag. The reference lab has confirmed the patients serum contains anti-Diego a antibodies. Clinically patients symptoms were of a hemolytic TR with tachycardia, back pain, dark urine, nausea and anxiety. LDH doubled post transfusion, haptoglobin was low but is low usually for this patient. DAT was negative in the post-transfusion sample. My questions are two please. 1. Has anyone ever seen an immediate HTR due to a anti-Diego a antibody? 2. Do sickle cell patients experience 'stronger' symptoms of transfusion reactions? Thanks From the Lab Down Under.