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haematology > Blood Transfusion Complications > Flashcards

Blood Transfusion Complications Flashcards

1
Q

what is the cause behind a non-haemolytic febrile reaction?

transfusion reaction

A

caused by antibodies reacting with white cell fragments (HLA antibodies) in the blood products and cytokines that have leaked from the blood cell during storage

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2
Q

what are the features of non-haemolytic febrile reaction?

transfusion reaction

A
  • fever
  • chills
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3
Q

what type of transfusion is non-haemolytic febrile reaction most commonly associated with?

A

platelet transfusion

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4
Q

what is the management of a non-haemolytic febrile reaction?

transfusion reaction

A
  • slow or stop the transfusion
  • paracetamol
  • monitor
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5
Q

what is the cause of a minor allergic reaction?

transfusion reaction

A

foreign plasma proteins

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6
Q

what features does a minor allergic reaction present with?

transfusion reaction

A
  • occurs within minutes of starting the transfusion
  • pruritus
  • urticaria
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7
Q

what is the management of a minor allergic reaction?

transfusion reactions

A
  1. temporarily stop the transfusion
  2. anti-histamine
  3. monitor
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8
Q

what is the cause of anaphylaxis?

transfusion reactions

A

caused by patients with IgA deficiency who have anti-IgA antibodies

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9
Q

what is the typical presentation of anaphylaxis?

transfusion reactions

A
  • occur within minutes of starting the transfusion
  • hypotension
  • dyspnoea
  • wheezing
  • angioedema
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10
Q

what is the management of anaphylaxis?

A
  1. stop the transfusion
  2. IM adrenaline
  3. ABC support - e.g. oxygen, fluids
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11
Q

how does acute haemolytic transfusion reaction present?

transfusion reaction

A
  • begins minutes after transfusion is started
  • fever
  • abdominal and chest pain
  • hypotension
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12
Q

what is the management for acute haemolytic transfusion reaction?

transfusion reactions

A
  1. stop transfusion
  2. confirm diagnosis
  3. fluid resuscitation
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13
Q

how is acute haemolytic transfusion reaction confirmed?

transfusion reactions

A
  • check the identity of the patient/name on blood product
  • send blood for direct Coombs test
  • repeat typing and cross-matching
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14
Q

what are the complications of an acute haemolytic transfusion reaction?

transfusion reactions

A
  • disseminated intravascular coagulation
  • renal failure
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15
Q

what is the pathophysiology of an acute haemolytic transfusion reaction?

transfusion reaction

A
  1. incorrect blood matching
  2. red blood cell destruction by IgM-type antiboides
  3. intravascular haemolysis
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16
Q

what type of haemolysis occurs in acute haemolytic transfusion reaction?

transfusion reactions

A

intravascular haemolysis

17
Q

what is an acute haemolytic transfusion reaction?

transfusion reaction

A

ABO-incompatible blood (e.g. mismatch of blood group)

18
Q

what is transfusion-associated circulatory overload (TACO)?

transfusion reactions

A

excessive rate of transfusion, pre-existing the heart failure

19
Q

how does transfusion-associated circulatory overload (TACO) present?

transfusion reactions

A
  • pulmonary oedema
  • hypertension
20
Q

how is transfusion-associated circulatory overload (TACO) managed?

transfusion reactions

A
  1. slow or stop transfusion
  2. consider IV loop diuretic (e.g furosemide)
  3. oxygen
21
Q

what is the pathophysiology of transfusion-related acute lung injury (TRALI)?

transfusion reactions

A
  1. host neutrophils become activated by substances in donated blood
  2. increased vascular permeability
  3. non-cardiogenic pulmonary oedema
22
Q

how does transfusion-related acute lung injury (TRALI) present?

transfusion reactions

A
  • occurs within 6 hours of transfusion
  • hypoxia
  • pulmonary infiltrates on chest x-ray
  • fever
  • hypotension
23
Q

how is transfusion-related acute lung injury (TRALI) managed?

transfusion reactions

A
  1. stop the transfusion
  2. oxygen and supportive care
24
Q

what is transfusion-related acute lung injury (TRALI)?

transfusion reactions

A

neutrophilic mediated allergic pulmonary oedema

25
Q

what is graft vs host disease typically associated with?

transfusion reactions

A

transfusion of unirradiated blood in immunosuppressed patients

26
Q

how does transfusion associated graft vs host disease (GVHD) present?

transfusion reactions

A
  • 4-30 days post transfusion
  • sub-acute
  • diarrhoea
  • abnormal liver function tests
27
Q

how is transfusion associated graft vs host disease (GVHD) managed?

transfusion reaction

A

steroid therapy

28
Q

what increases your likelihood of having an anaphylaxic blood transfusion reaction?

A

IgA deficiency

29
Q

how is TRALI differentiated from TACO clinically?

A

hypotension = TRALI
hypertension = TACO

30
Q

what type of infection is most likely to be transmitted during platelet transfusion?

A

bacterial

platelet concentrates are generally stored at room temp therefore more likely to be contaminated by bacteria

haematology (14 decks)

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