Transfusion reactions - NYSORA

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Transfusion reactions

Learning objectives

  • Describe the different types of transfusion reactions
  • Recognize the signs of the different types of transfusion reactions
  • Take preventative measures against transfusion reactions
  • Manage the occurrence of transfusion reactions

Definition & mechanisms

  • Transfusion reactions are the most frequent adverse event associated with the administration of blood products, occurring in up to one in 100 transfusions
  • There are several types of adverse reactions:
    • Allergic/Anaphylactic reactions
    • Acute hemolytic reactions
    • Delayed hemolytic reactions
    • Febrile non-hemolytic reactions
    • Hyperhemolytic reactions
    • Hypotensive reactions
    • Massive transfusion-associated reactions
    • Post-transfusion purpura
    • Septic reactions
    • Transfusion-associated circulatory overload
    • Transfusion-associated graft versus host disease
    • Transfusion-associated necrotizing enterocolitis
    • Transfusion-related acute lung injury

Signs & symptoms

transfusion reactions, signs, symptoms, temperature, allergic, respiratory, chills, rigors, hypotension, nausea, vomiting, hives, rash, itching, swelling, bronchospasm, dyspnea, tachypnea, hypoxemia, chest pain, cough, hypoxia, febrile nonhemolytic reaction, bacterial contamination, hemolysis, urticaria, anaphylaxis, circulatory overload, septic, acute lung injury

Prevention

  • Comprehensive training of staff
  • Close adherence to blood handling and administration policies
  • Laboratory testing
  • Prospective monitoring and planning
  • A restrictive transfusion strategy to avoid unnecessary transfusions

Management

transfusion reactions management, urticaria, allergic, febrile nonhemolytic, bacterial contamination, hemolysis, anaphylaxis, hemolytic, circulatory overload, septic, acute lung injury, vital signs, antipyretic, blood cultures, antibiotics, neutropenic, sepsis, laboratory, antihistamines, adrenaline, steroids, oxygen, diuretics, blood pressure, renal, pulmonary support, radiograph, interstitial infiltrate, lung injury, sepsis

Suggested reading

  • Delaney M, Wendel S, Bercovitz RS, et al. Transfusion reactions: prevention, diagnosis, and treatment. Lancet. 2016;388(10061):2825-2836.

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