Recommended guidelines for diagnosis of DHTR in adult patients with SCD. (A) Our assessment criteria to diagnose DHTR in adult SCD patients who are recently transfused is based on clinical and laboratory features (pain, anemia, urine color, elevated LDH) and immune-hematologic analysis, which may or may not reveal the presence of new antibodies. If DHTR is suspected, we recommend using immediate posttransfusion total Hb in g/dL and HbA% following the nomogram shown, to determine the likelihood that a patient is experiencing DHTR. The formula can be calculated directly by using the link provided in the figure. (B) Based on total Hb and HbA%, DHTR was suspected for cases 2 and 3, but not for case 1, as confirmed by the nomogram.