Fever, hemoglobinemia, hemoglobinuria, oliguria, and a marked fall in hematocrit values developed in a patient with a bleeding peptic ulcer 13 days after he had received 4 units of apparently compatible blood. He went on to become frankly uremic and hyperkalemic, but eventually recovered. Results of routine serologic studies at the time of the transfusion reaction were normal, but an anti-Jkb antibody could be demonstrated when cells treated with trypsin were used in the indirect Coombs' test; the patient's blood type was found to be Jk (a +b-); the blood type of three of his four donors was Jk(b+).
Holland PV, Wallerstein RO. Delayed Hemolytic Transfusion Reaction With Acute Renal Failure. JAMA. 1968;204(11):1007-1008. doi:10.1001/jama.1968.03140240063023