A 55-Year-Old Man Is Hospitalized After a Massive Hemorrhage from a Duodenal

A 55-year-old man is hospitalized after a massive hemorrhage from a duodenal ulcer.  The bleeding is stopped with endoscopic manipulation.  The patient receives 2 L of intravenous fluids, followed by 2 units of packed red blood cells.  Two hours after the transfusion is started, he develops chills and malaise.  Temperature is 38.7 C (101.7 F) , blood pressure is 120/76 mm Hg, pulse is 100/min, and respirations are 20/min.  The transfusion is stopped, and the patient is given acetaminophen.  Direct antiglobulin and plasma-free hemoglobin level tests are negative.  Urinalysis is within normal limits.  The symptoms resolve within 6 hours of transfusion discontinuation.  Which of the following is the best procedure for preventing this type of transfusion reaction?

A) Careful cross-matching of blood
B) Infusing calcium gluconate
C) Premedicating with diphenhydramine
D) Using a leukoreduced blood product
E) Warming the blood product

Correct Answer:

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