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The receiving organism (the person getting the blood) does not recognise the proteins on the outside of the cells, and so treats them like any other foreign object: attack and destroy. Because a transfusion is such a large amount of blood, the body wages allout war which it cannot sustain, so eventually wears itself out. The body can't handle the combined shock of a response like this and whatever ailment required the transfusion in the first place.

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