17 - Transfusion Reactions Flashcards
MCC death from transfusions
TRALI
urticarial reactions to transfusions are generally caused by
reaction to protein in plasma related products
pts at higher risk for anaphylaxis after transfusion
IgA deficiency
no 1 thing to do when there is a transfusion rxn
stop transfusion
MCC acute hemolytic transfusion reaction
clerical/administration error - giving wrong blood to wrong pt!
time cutoff btwn acute and delayed hemolytic transfusion reaction
24 hrs
quantitative threshold for TRALI
O2 sat <90% on room air
how much iron in a unit of blood?
200 mg
cause of acute hemolytic transfusion reaction
ABO mismatch / major RBC antigen reaction
labs indicating acute hemolytic transfusion reaction
pos DAT, pos elution test w/ alloantibody on RBCs
usually 2+ of: dec fibrinogen, dec haptoglobin, elevated bilirubin, elevated LDH, heomglobinemia/uria
cause of delayed hemolytic transfusion reaction
primary or secondary alloimmunization to minor antigen
DHTR lab findings
pos DAT, pos elution test, inadequate rise or a drop in hgb after transfusion or unexplained spherocytes
LDH and bilirubin will have fallen back to normal by then
cause of febrile non hemolytic transfusion reaction
recipient ab to donor wbc/platelets
what processing can be done to reduce occurrence of febrile transfusion reactions?
leukocyte reduction
time frame for TRALI
1-6 hrs after transfusion
