Leukoagglutinins are antibodies that react with white blood cells and sometimes cause febrile transfusion reactions. Patients who exhibit this type of transfusion reaction should receive leukocyte-poor blood for any subsequent transfusions.

This study is done when a transfusion reaction occurs even though compatible blood has been given. The donor plasma contains an antibody that reacts with recipient white cells to produce an acute clinical syndrome of fever, dyspnea, cough, pulmonary infiltrates, and, in more severe cases, cyanosis and hypertension. Patients immunized by previous transfusions, by pregnancy, or during allografts often experience these febrile, non-HTRs because of incompatible transfused leukocytes. This type of reaction must be confirmed (as compared with hemolytic reactions) before additional transfusions can be safely administered.

• Negative for leukoagglutinins

1. Obtain a 10-mL venous blood sample. Observe standard precautions.

2. Label the specimen with the patient’s name, date, and test(s) ordered and place in a biohazard bag for transport to the laboratory.

1. Agglutinating antibodies may appear in the donor’s plasma.

2. When the agglutinating antibody appears in the recipient’s plasma, febrile reactions are common; however, pulmonary manifestations do not occur.

3. Febrile reactions are more common in pregnant women and in individuals with a history of multiple transfusions.

Pretest Patient Care

1. Explain test purpose and procedure.

2. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.