Does anyone include haptoglobin tests in their transfusion reaction workup (probably just the extended workup when hemolytic reaction is expected)?

Just now, Mabel Adams said:

Does anyone include haptoglobin tests in their transfusion reaction workup (probably just the extended workup when hemolytic reaction is expected)?

I remember the great George Garratty telling me once that measuring haptoglobins AFTER blood has been given is an absolute waste of time, money and reagents, UNLESS the pre-transfusion haptoglobin levels have been measured.

I believed him!!!!!!!!!!!!!!!!!!!!

Where I work, it's up to the pathologist to request haptoglobin test on the transfusion reaction case. 

Even without a transfusion reaction, the haptoglobin drops with transfusion of red cells.  Lots of non-viable cells and free hemoglobin in many red cell transfusions.  If you cannot see red urine, red plasma and a drop in hematocrit/failure to rise, it's not a hemolytic reaction.  Haptoglobin plays almost no role in assessing hemolytic transfusion reactions, and, as mentioned, unless you measure it on the pre-transfusion sample as well, tells you almost nothing.  LDH pre and post would be more useful in most cases. Don't bother with haptoglobin in most cases.