The relation of the isoagglutinins in pooled plasma to the haemolytic anaemia of burns.

Patients showing red cell loss following severe burns have been considered in two groups, the more severe cases with late haemoglobinuria and the more numerous less severe cases without late haemoglobinuria. Patients who had late haemoglobinuria usually belonged to group A or AB, showed a normal or increased osmotic fragility of red cells, and had received more than three plasma volumes of pooled plasma. It is suggested that this haemolytic anaemia may have been caused by the anti-A isoagglutinins in pooled plasma or serum. Patients showing red cell loss but who had no late haemoglobinuria had a normal ABO group distribution and an increased osmotic resistance of their red cells. It is concluded that this more common type of red cell loss in burns is independent of transfused isoagglutinins. Isoantibodies present in pooled plasma have been investigated. Corresponding antibodies have been demonstrated in the serum of groups A and AB patients transfused with moderate quantities of pooled plasma. The same patients commonly also had a raised erythrocyte sedimentation rate, without there being a clinically important red cell loss.