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Anaphylactic reactions are excluded by the presence of red plasma or urine, discordant pretransfusion and posttransfusion ABO blood types, or a positive direct antiglobulin (Coombs) test result. Demonstration of anti-IgA in a pretransfusion sample of the recipient's serum or plasma establishes the diagnosis.
The IV tubing used to transfuse the blood components should be clamped and sent without the needle attached. A urine sample is not required for the routine evaluation of a transfusion reaction, but may be requested by the Blood Bank physician in the course of further assessment.