A post transfusion properly labelled blood sample, (avoiding haemolysis)
should be obtained from the patient and sent to transfusion service
along with blood container and attached transfusion set The patient's post-reaction serum or plasma should be inspected for
evidence of haemolysis, comparing with pre-transfusion sample A direct antiglobulin test should be done on the post transfusion specimen
and on pre reaction sample for comparison Based on evaluation of clinical findings, review of accuracy of records
and results of laboratory tests, additional tests should be done such as Determination of ABO and Rh(D) types on pre and post reaction blood
sample from the patient and from the blood bag Repeat tests for unexpected antibodies in donor and recipients’ blood
and repeat cross-match using pre and post reaction blood samples of
the patient and donor blood from the bag Examination of post transfusion urine should be carried out for
haemoglobin and its metabolites Determination of bilirubin concentration in serum should be obtained
preferably 5 to 7 hours after the transfusion Supernatant plasma and remaining blood in the blood container as well
as the post-reaction sample of the patient should be tested for smear
and culture.Expiry dated blood units should be tested periodically for
bacteriological smear and culture If investigations are suggestive of a haemolytic reaction or bacterial
contamination, patient's physician should be informed immediately.