Adverse Transfusion Reactions Flashcards
(39 cards)
Why is there a risk for viral transfusion transmission of HIV and hepatitis C even though the donor blood is tested?
If donation occurred during the window period of the infection, the viral load would be below the detection limit
Why should you stop a transfusion immediately when a transfusion reaction is expected?
The volume of blood transferred is positively correlated with mortality
What are the three types of acute febrile transfusion reactions?
Acute hemolytic transfusion reaction (AHTR), febrile non-hemolytic transfusion reaction (FNHTR), and septic reaction due to bacterial contamination
What is the diagnostic criteria for an acute febrile transfusion reaction?
Body temperature is >1ºC over baseline or chills/rigors are present
Which of the acute febrile transfusion reactions is benign?
FNHTR
What is the mechanism of AHTR?
Patient preformed antibodies activate compliment and cause intravascular hemolysis of donor RBCs
What is the most common cause of AHTR?
Clerical mistakes leading to transfusion of ABO incompatible blood (blood administered to the wrong patient, wrong identification of blood specimen)
What are the classic symptoms of AHTR?
Fever with or without chills, DIC, hypotension, gross hemoglobinuria, renal failure, pain at infusion site or back/flank
Which adverse transfusion reaction classically presents with fever, DIC, hypotension, and renal failure?
AHTR
What lab abnormalities would you see with AHTR?
Postitive Coomb’s; decreased haptoglobin; increased LDH and indirect bilirubin; positive urine hemoglobin
What adverse transfusion reaction is most likely in a patient with a positive Coomb’s test, decreased haptoglobin, increased LDH and indirect bilirubin, and positive urine hemoglobin?
AHTR
Which blood product is most likely to cause a septic reaction?
Platelets due to room temperature storage
What pathogens are usually found in contaminated platelets?
Gram positive bacteria (staph/strep, etc.)
What pathogens are usually found in contaminated RBC products?
Gram negative bacteria
Is bacterial contamination more likely in platelets or RBC transfusion products?
Platelets
Which contaminated blood product causes more serious septic reactions?
RBC products
What are the classic symptoms of a septic transfusion reaction?
High fever that does not respond to anti-pyretics, rigor/chills, hypotension, tachycardia, nausea/vomiting, shortness of breath, DIC
Which adverse transfusion reaction commonly presents with a high fever that does not respond to anti-pyretics, rigor/chills, hypotension, tachycardia, nausea/vomiting, shortness of breath, and DIC?
Septic transfusion reaction
What lab abnormalities would you see in a septic transfusion reaction?
Positive bacteria culture in remainder of transfused blood product with or without positive recipient blood culture, negative Coomb’s, evidence of DIC
What is the most likely proposed mechanism of FNHTR?
WBCs in donor blood initiate inflammatory response
What is the most common adverse febrile transfusion reaction?
FNHTR
What are the classic symptoms of FNHTR?
Fever during or soon after transfusion with or without chills
What are the symptoms of a mild allergic transfusion reaction?
Cutaneous symptoms only (urticaria, rash)
What are the classic symptoms of an anaphylactic transfusion reaction?
Angioedima, bronchospasm/SOB/wheezing, GI symptoms, hypotension, cardiovascular collapse
