24th May 2023

A 35-year-old patient with a history of beta thalassaemia major is referred from the emergency department

A 35-year-old patient with a history of beta thalassaemia major is referred from the emergency department, having been unwell for the last few weeks. He describes increased shortness of breath and fatigue. In the last 4 days he has developed increasing abdominal pain with no vomiting or diarrhoea. He tells you that he has required blood transfusions more frequently in the last 12 months due to his anaemia. He is also taking iron chelation therapy. On examination he has a blood pressure of 105/60mmHg, heart rate 110bpm, temperature 36.5˚C and abdominal tenderness with a large, palpable mass in the right side of his abdomen extending down towards his pelvis. Some of his blood tests in the emergency department have come back and show the following:

Which one of the following options should be considered following blood transfusion?