{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:04:33Z","timestamp":1784307873942,"version":"3.55.0"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Massive transfusion protocols are essential in trauma resuscitation but may inadvertently increase the risk of acute hemolytic transfusion reactions (AHTRs), which are typically caused by ABO incompatibility. Recognition is difficult because signs of hemolysis can mimic trauma\u2010related hemorrhage or coagulopathy. Cognitive biases in emergency decision\u2010making may further delay diagnosis. Although ABO\u2010incompatible AHTR remains exceptionally rare in trauma, it is easily overlooked in the context of polytrauma. We describe three cases of ABO\u2010incompatible AHTR admitted to a tertiary trauma center. First, a 52\u2010year\u2010old man with multiple injuries received three mis\u2010issued AB+ units instead of group O blood. He developed hemoglobinuria, coagulopathy, and fatal multiorgan failure. The second case involved an 81\u2010year\u2010old man with multiple comorbidities who underwent hip fracture fixation; due to a mislabeled admission sample, he received A+ instead of B+ blood, resulting in persistent anemia, renal failure, and death. The third case was a 30\u2010year\u2010old woman with severe head and thoracic trauma who received incompatible blood under an emergency release protocol. She developed hemolysis, neurologic decline, and sepsis, and ultimately died of multiorgan failure. In all three patients, early post\u2010transfusion anemia and hemodynamic instability were attributed to trauma, delaying recognition of hemolysis. AHTR may therefore be overlooked in trauma settings, where its manifestations overlap with injury\u2010related complications and cognitive biases such as anchoring and premature closure may impair diagnostic reasoning. Strict transfusion safety protocols, heightened vigilance when hemoglobin levels fail to rise, and awareness of cognitive errors may improve early recognition and patient outcomes.<\/jats:p>","DOI":"10.1002\/ccr3.72944","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T03:59:44Z","timestamp":1781755184000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cognitive Biases in Early Trauma Transfusions: Lessons From Three Rare Cases of Acute Hemolytic Reaction"],"prefix":"10.1002","volume":"14","author":[{"given":"Mohammad Javad","family":"Entezari Meybodi","sequence":"first","affiliation":[{"name":"Student Research Committee, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samin","family":"Jodari Dallali","sequence":"additional","affiliation":[{"name":"School of Pharmacy Inonu University  Malatya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9102-8505","authenticated-orcid":false,"given":"Hosein","family":"Kouchaki","sequence":"additional","affiliation":[{"name":"Health Policy Research Center, Institute of Health Shiraz University of Medical Sciences  Shiraz Iran"},{"name":"Trauma Research Center Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Golnar","family":"Sabetian","sequence":"additional","affiliation":[{"name":"Trauma Research Center Shiraz University of Medical Sciences  Shiraz 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