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Posted On Aug 29, 2018

Updated On Dec 04, 2025

Transfusing IMHA Patients

Internal Medicine

These questions were asked during a past webinar on the topic of immune-mediated hemolytic anemia in dogs:


Questions:

1)  Have you seen a clinical difference in patients that receive fresh pRBCs
(<2 wks old ) vs older units? 

2)  I run a large dog blood bank and we get calls for product for IMHA dogs all the time. Do you have a preference for using the blood type of these patients for their transfusion and cross matching any units used? Or would you go with a universal donor always?


Answer by Linda Kidd, DVM, PhD, DACVIM (SAIM):

Regarding question 1:  Great question! A very large study showed increased mortality associated with pRBC age only in dogs with hemolysis, the majority of whom had IMHA. We completed a study that adds to human and veterinary studies that show that procoagulant microparticles accumulate in aged units (to be submitted for publication). We have also shown that procoagulant microparticles are increased in some dogs with IMHA. Kidd L, Geddings J, Hisada Y. Procoagulant microparticles in dogs with immune-mediated hemolytic anemia. J Vet Intern Med. 2015;29(3):908-16

Others have shown that procoagulant NETS (neutrophil extracellular traps) increase in stored PRBCs and are increased in some dogs with IMHA. Jeffery U, Ruterbories L, Hanel R. et al. Cell-Free DNA and DNase Activity in Dogs with Immune-Mediated Hemolytic Anemia. J Vet Intern Med. 2017.  Sept. 31(5):1441-1450

Interestingly a study investigating the nature of the red cell targets of antibody induced in dogs by Babesia infection showed more reactivity to aged RBCs. Therefore there are a number of reasons why fresh units are indicated in these patients. 

Regarding question 2:  This great question is better addressed by the clinical pathologists and others who perform the tests. It is actually addressed in the treatment of IMHA in dogs section of the Consensus Statement published in the Journal of Veterinary Internal Medicine. I would recommend crossmatching if possible to find the best donor for an individual patient. Apparently autoagglutination interferes with some of the typing POC tests, speaking to a clinical pathologist and the manufacturers may help answer your question. 


Learn more about IMHA in Dogs