ransfusion Reactio

In medicine, a
transfusion reaction
is any adverse event
which occurs
because of a
blood transfusion.
form
of an;
•allergic reaction
•transfusion-related
infection
•hemolysis related to an
incompatible blood type
•an alteration of the
immune system related to
the transfusion.
transfusion
reaction must
always be
balanced against
the anticipated
benefit of a blood
transfusion.
Types of Transfusion
Reactions
Febrile non-hemolytic
transfusion reaction. This is
the most common adverse
reaction to a blood transfusion.
Symptoms include fever and
dyspnea 1 to 6 hours after
receiving the transfusion.
Such reactions are clinically
benign, causing no lasting side
effects or problems, but are
unpleasant. Risk is estimated, as
of 2006, at 1 per 2 million units
Bacterial infection. Blood
products can provide an excellent
medium for bacterial growth, and
can become contaminated after
collection while they are being
stored. The risk is highest with
platelet transfusion, since
platelets must be stored near
room temperature and cannot be
refrigerated.
The risk of severe bacterial infection
and sepsis is estimated (2001) at about
1 in 50,000 platelet transfusions
Acute hemolytic reaction. This is a
medical emergency resulting from
rapid destruction (hemolysis) of the
donor red blood cells by host
antibodies.
The most common cause is
clerical error (i.e. the wrong unit of
blood being given to the wrong
patient).
The symptoms are fever and chills,
sometimes with back pain and pink or
red urine (hemoglobinuria).
The major complication is that
Anaphylactic reaction. An
anaphylactic (or severe allergic)
reaction can occur at a rate of 1 per
30,000-50,000 transfusions.
These reactions are most common
in people with
selective IgA deficiency (although
IgA deficiency is often
asymptomatic, and people may not
know they have it until an
anaphylactic reaction occurs).
An anaphylactic reaction is a
Transfusion-associated
acute lung injury (TRALI).
TRALI is a syndrome of acute
respiratory distress, often
associated with fever, non-
cardiogenic pulmonary edema,
and hypotension.
It may occur as often as 1 in
2000 transfusions. Symptoms
can range from mild to life-
threatening, but most patients
recover fully within 96 hours,
Volume overload. Patients with
impaired cardiac function (eg
congestive heart failure) can
become volume-overloaded as a
result of blood transfusion,
leading to edema, dyspnea
(shortness of breath), and
orthopnea (shortness of breath
while lying flat).

This is sometimes called TACO, or

Transfusion Associated Circulatory
Iron overload. Each transfused
unit of red blood cells contains
approximately 250 mg of elemental
iron. Since elimination pathways for
iron are limited, a person receiving
numerous red blood cell
transfusions can develop
iron overload, which can in turn
damage the liver, heart, kidneys,
and pancreas. The threshold at
which iron overload becomes
significant is somewhat unclear, but
Transfusion-associated graft-vs-host
disease (GVHD). GVHD refers to an
immune attack by transfused cells against
the recipient. This is a very rare
complication of blood transfusion. It occurs
only in severely immunosuppressed
patients, primarily those with congenital
immune deficiencies or
hematologic malignancies who are
receiving intensive chemotherapy.
When GVHD occurs in association with
blood transfusion, it is almost uniformly
fatal. Transfusion-associated GVHD can be
reactions
•Stop the transfusion
immediately (saving the
remaining blood and IV tubing for
testing) and to provide
supportive care to the patient.
•More specific treatments depend
on the nature and presumed
cause of the transfusion reaction.
Most hospitals and
medical centers have transfusion
reaction protocols, which specify
testing of the blood product and
patient for hemolysis, bacterial