Acute hemolytic transfusion reaction is due antibodies directed against which of the following blood group antigens?

Ans. D. All of the above. (Ref. Harrison's 17th/pg, 710).Harrison's 17th/pg. 710.Acute Hemolytic Transfusion ReactionsImmune-mediated hemolysis occurs when the recipient has preformed antibodies that lyse donor erythrocytes. The ABO isoagglutinins are responsible for the majority of these reactions, although alloantibodies directed against other RBC antigens, i.e., Rh, Kell, and Duffy, may result in hemolysis.Acute Hemolxtic Transfusion Reactions#Immune-mediated hemolysis occurs when the recipient has preformed antibodies that lyse donor erythrocytes. The ABO isoagglutinins are responsible for the majority of these reactions, although allo antibodies directed against other RBC antigens, i.e., Rh, Kell, and Duffy, may result in hemolysis.#Acute hemolytic reactions may present with hypotension, tachypnea, tachycardia, fever, chills, hemoglobinemia, hemoglobinuria, chest and/or flank pain, and discomfort at the infusion site. Monitoring the patient's vital signs before and during the transfusion is important to identify reactions promptly.#When acute hemolysis is suspected, the transfusion must be stopped immediately, intravenous access maintained, and the reaction reported to the blood bank. A correctly labeled post transfusion blood sample and any non transfused blood should be sent to the blood bank for analysis. The laboratory evaluation for hemolysis includes the measurement of serum haptoglobin, LDH, and indirect bilirubin levels.#The immune complexes that result in RBC lysis can cause renal dysfunction and failure. Diuresis should be induced with intravenous fluids and furosemide or mannitol. Tissue factor released from the lysed erythrocytes may initiate DIC.#Errors at the patient's bedside, such as mislabeling the sample or transfusing the wrong patient, are responsible for the majority of these reactions. The blood bank investigation of these reactions includes examination of the pre- and post transfusion samples for hemolysis and repeat typing of the patient samples; direct antiglobulin test (DAT), sometimes called the direct Coombs test, of the posttransfusion sample; repeating the cross-matching of the blood component; and checking all clerical records for errors. DAT detects the presence of antibody or complement bound to RBCs in vivo.