Antibody-induced hemolytic transfusion reactions were first described over 300 years ago. Indeed, during its early evolution, transfusion medicine focused almost exclusively on issues in immunohematology to prevent such events. However, despite the best of efforts to avoid them, incompatible transfusions still occur, through both error and an inability to obtain compatible red blood cells for patients who are alloimmunized against multiple antigens. Because transfusing units of incompatible blood is potentially lethal, studies on human volunteers are not ethical. Thus, understanding of hemolytic transfusion reactions is generated through clinical cases, animal models, inference from related human pathologies, or studies using small volumes of transfused red blood cells. Over the past several decades, substantial new knowledge has been accumulated regarding the mechanisms of hemolysis, the metabolism of products of hemolysis, and the effects of both on recipient biology. Using these data sources, this article traces the historical generation of this knowledge and describes recent advances.

中文翻译：

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输血反应的病理生物学。

抗体诱导的溶血性输血反应最早是在300多年前描述的。确实，在其早期发展过程中，输血医学几乎完全集中在免疫血液学方面的问题上，以防止此类事件的发生。然而，尽管尽了最大的努力来避免它们，但是由于错误和不能针对多种抗原同种免疫的患者无法获得相容的红细胞，仍然发生了不相容的输血。由于输注不相容血液可能会致命，因此对人类志愿者的研究是不道德的。因此，对溶血性输血反应的了解是通过临床病例，动物模型，从相关人类病理学推断或使用少量输血红细胞的研究得出的。在过去的几十年中，关于溶血的机理，溶血产物的代谢以及两者对受体生物学的影响，已经积累了相当多的新知识。本文使用这些数据源来追溯此知识的历史产生并描述最新进展。