adverse transfusion reactions Flashcards
what is the case of acute hemolytic reaction ?
ABO incompatability
what kind of haemolysis is associated with AHTR ?
intravascular haemolysis
what is the clinical picture of AHTR ?
1- reaction develops within 1 hour off thee transfusion
2- abrupt onset
3- fever hypotension and anxiety
what is the management of AHTR ?
stop the transfusion
notify blood bank
give saline
what type of allergic reaction is associated with blood transfusion ?
type 1 hypersensitivity reaction IgE mediated
what is the presentation of the allergic reaction associated with blood transfusion ?
uurticaria
fever
what is the management of this allergic reaction ?
stop the transfusion
anti histamines
what is the cause of severe allergic/anaphylactic reactions due to blood transfusion ?
IgA deficient donor receiving an IgA containing product
what is the clinical presentation of the anaphylactic reaction ?
hypotension
cardiovascular instability
shock
airway compromise
what is the management of the anaphylactic shock ?
immediately stop the transfusion
resuscitate
antihistamine and corticosteroids
adrenaline may be indicated
what can be done as prevention of anaphylactic shock ?
washed cells
reduced IgA blood products
what is the recommended transfusion time ?
4 hours
what type of bacteria are likely to affect RBCs stored at 4C ?
gram negative bacteria
what type of bacteria are more likely to affect platelets stored at room temperature ?
gram positive bacteria
what is the clinical picture of transfusion related acute lung injury ?
presents with pulmonary oedema and can cause ARDS
what type of blood component is associated with TRALI ?
plasma transfusion
what is the pathogenesis of TRALI ?
associated with anti HLA antibodies
what is the presentation of febrile non hemolytic transfusion reaction ?
fever up to 2 hours after thee transfusion but otherwise the patient is well
what is the management of febrile non hemolytic transfusion reaction ?
slow down the transfusion and give paracetamol
what can be done for prevention of febrile nonhemolytic transfusion reaction ?
leuko reduction
what is the presentation of transfusion associated circulatory overload?
signs of heart failure
volume overload
what is the management of TACO ?
slow the transfusion down and give furosemide
what is the definition of massive blood transfusion ?
transfusion of 10 units of blood or complete replacement of circulating volume in 24 hours
what are the criteria to trigger the activation of an MTP ?
one or more of thee following :
1- ABC score of two or more persistent hemodynamic instability
2- active bleeding requiring operation or angioembolization
3- blood transfusion in trauma bay
what are the complications associated with massive transfusion ?
coagulopathy ((dilutional coagulpathy )
hypothermia
acid base abnormalities
electrolyte abnormalities
why might there be acid base abnormalities ?
due to the presence of lactic acid and citric acid in the blood bag
what is the ratio between RBC and plasma ?
1:1
what is the cause of delayed hemolytic transfusion reaction ?
caused by an exaggerated response to a foreign red cell antigen
what is the presentation of delayed hemolytic transfusion reaction ?
happens up to 5 days post op
patient may be asymptomatic or have a slight fever
what is the cause of transfusion associated graft versus host disease ?
thee donor’s lymphocytes attack the recipients
what is the onset of Ta-GHVD ?
from 8-10 days post transfusion
how can Ta-GHVD be prevented ?
gamma irradiation of cellular blood products
what is the cause of post transfusion purpra ?
1- the recipient always has a history of sensitization, mostly by pregnancy
2- HPA-1A negative patients with previous exposure to Anti-HPA-1A
what is the clinical picture of post transfusion purpra ?
1- occurs 5-10 days after transfusion
2- severe sudden and self limiting thrombocytopenia
3-platelet count is less than 10
