A condition called hemolytic anemia may occur if an Rh-negative person
receives a transfusion of Rh-positive blood. The recipient can, over a
period of several weeks, develop antibodies called anti-Rh agglutinins
as a reaction to the Rh-positive blood. These antibodies attach to the
Rh-positive red blood cells, and hemolysis may result (hemolysis is a
process in which red blood cells are broken down prematurely, leaving
fewer red blood cells available for the transport of oxygen, and
releasing free hemoglobin into the patient's bloodstream). If the
patient receives a second transfusion of Rh-positive blood, the
reaction may become severe.
In the situation which you describe, in which two transfusions were
only 48 hours apart, not enough time would have passed between the
first transfusion and the second to allow a significant buildup of
anti-Rh agglutinins, so it would be unlikely that the second
transfusion would cause an immediate adverse reaction. However, there
could be severe consequences if a third Rh-positive transfusion were
to be given in the future (or if the patient is female and later
becomes pregnant with an Rh-positive child).
Sometimes, in emergency situations, it may become necessary to
transfuse an Rh-negative patient with Rh-positive blood. In such
cases, an immunoglobulin product such as RhoGAM may help reduce the
severity of the reaction:
"RhoGAM® and MICRhoGAM® Rho(D) Immune Globulin (Human) are sterile solutions
containing IgG anti-D (anti-Rh) for use in preventing Rh immunization...
INDICATIONS AND USAGE...
Prevention of Rh immunization in any Rh-negative person after
incompatible transfusion of Rh-positive blood or blood products (e.g.,
red cells, platelet concentrates, granulocyte concentrates)"
BabyCenter: RhoGAM
http://www.babycenter.com/rhogam/info.pdf
More info on the immune reaction that can occur when an Rh-negative
person is given Rh-positive blood:
"If an Rh-negative receives Rh-positive blood, the Rh-negative person
becomes sensitised and produces antibodies to the Rh factor. If on a
future occasion more blood of Rh-positive type is received, or a
Rh-positive foetus is conceived, the antibodies will cause
agglutination of the Rh-positive cells."
UniSAnet: The Cardiovascular System
http://www.unisanet.unisa.edu.au/12148/whynursweb2/Nursweb/Tutorials/Documents/The%20Cardiovascular%20system%20edit.htm
"When red blood cells containing Rh factor are injected into a
Rh-negative person, anti-Rh agglutinins develop slowly. If an
Rh-negative person has never been exposed to Rh-positive blood,
transfusion of Rh-positive blood into that person causes no immediate
reaction. However, in some of these people, anti-Rh antibodies develop
in sufficient quantities during the next 2 to 4 weeks to cause
agglutination of the transfused cells that are still circulating in
the blood... On subsequent transfusion of Rh-positive blood into the
same person, who is now immunized against the Rh factor, the
transfusion reaction is greatly enhanced and can become severe."
NUS Medical Humanities Research Group: Hemolytic Disease
http://www.geocities.com/m1physiology/tys/blood/blood4.htm
"If Rh-positive blood is transfused into an Rh-negative person, the
latter will gradually develop antibodies called anti-Rh agglutinins,
that attach to the Rh-positive red blood cells, causing them to
agglutinate. Destruction of the cells (hemolysis) eventually results.
If the Rh-negative recipient is given additional transfusions of
Rh-positive blood, the concentration of anti-Rh agglutinins may become
high enough to cause a serious or fatal reaction."
InfoPlease: Rh factor
http://www.infoplease.com/ce6/sci/A0841716.html
"If an Rh negative patient receives blood from an Rh positive donor
the negative patient may produce an antibody called Anti-D which may
cause a serious transfusion reaction the next time the patient
receives Rh Positive Blood. It is not standard practice for the blood
bank to issue Rh positive blood to an Rh negative recipient."
Crestwood Medical Center: Bloodbanking
http://www.crestwoodmedcenter.com/CustomPage.asp?PageName=Lab%20-%20Bloodbanking
"If an Rh-negative person receives a blood transfusion from an
Rh-positive person it can result in hemolysis and anemia."
Hyperdictionary: RH
http://www.hyperdictionary.com/dictionary/rh
"Problems arise when an Rh-negative person receives a transfusion from
an Rh-negative person, and they begin to produce antibodies against
the Rh factor. The next time Rh-positive blood is received, the
recipient's plasma agglutinins agglutinate the donor's RBCs."
McGraw-Hill Higher Education: The Circulatory System: Blood
http://www.mhhe.com/biosci/ap/saladin2e/student/olc/chap18studoutline.mhtml
Google Web Search: "transfusion reaction" + "rh factor"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=transfusion+reaction+%22rh+factor
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