267b adverse transfusion events

Question 1

transfusion allergic rxns - cause? symptoms? rx?

Answer 1

Type I hypersensitivity reaction (IgE) against plasma proteins in transfused blood.

Urticaria, pruritus, wheezing, fever.

Rx - antihistamine or Epi/steroids if severe

Question 2

transfusion febrile non-hemolytic rxns and rx?

Answer 2

Type II hypersensitivity reaction. Host antibodies against donor HLA antigens and leukocytes.

fever, chills, rigors

Rx - acetaminophen (antipyretics)

Question 3

transfusion-related circulatory overload symptoms and rx?

Answer 3

dyspnea, hypoxia, pulm edema

rx - diuresis

Question 4

acute hemolytic rxn - cause, symptoms, and rx?

Answer 4

Type II (Ab mediated cytotoxicity) hypersensitivity reaction. Intravascular hemolysis (ABO blood group incompatibility) or extravascular hemolysis (host antibody reaction against foreign antigen on donor RBCs).

Fever, hypotension, tachypnea, tachycardia, flank pain, hemoglobinemia (intravascular), jaundice (extravascular hemolysis).

rx - diuresis

Question 5

transfusion-related acute lung injury - cause and rx?

Answer 5

donor plasma has abs to patient WBCs –> diffuse pulmonary edema, dyspnea, hypoxia

from female donors who have had kids

Question 6

septic rxns - cause and rx?

Answer 6

bacteria in blood (usually because platelets stored at warmer temp) –> fever, chills, hypotension, shock

Rx- broad-spectrum antibiotics

Question 7

anaphylactic rxn - cause and rx?

Answer 7

Severe allergic reaction (type I - Anaphylactic) of host to things in donor plasma. IgA-deficient individuals must receive blood products that lack IgA.

Dyspnea, bronchospasm, hypotension, respiratory arrest, shock.

Rx - antihistamines, Epi, steroids

Question 8

Transfusion-associated Graft vs host disease

Answer 8

cellular immune rxn of donor lymphocytes vs host organs due to HLA matched donor or severe immunosuppression (patient isn’t rejected WBC which is normal) –> rash, fever, diarrhea, hepatitis, pancytopenia 3-30 days post transfusion

Question 9

Transfustion-associated Graft vs host disease

Answer 9

cellular immune rxn of donor lymphocytes vs host organs due to HLA matched donor or severe immunosuppression (patient isn’t rejected WBC which is normal) –> rash, fever, diarrhea, hepatitis, pancytopenia 3-30 days post transfusion