Complications of Transfusion

Question 1

What is the most common type of complication that occurs in transfusion reaction?

Answer 1

Febrile nonhemolytic reaction

Question 2

Describe Febrile nonhemolytic reaction.

Answer 2

Fever, chills, and mild dyspnea after 6 hours of transfusion of red cells or platelets.

Question 3

How is Febrile nonhemolytic reaction mediated?

Answer 3

Inflammatory mediators produced by the donor leukocytes

Question 4

What factor exacerbates Febrile nonhemolytic reaction?

Answer 4

The frequency of these reactions increases with the storage age of the product.

Question 5

What factor decreases Febrile nonhemolytic reaction?

Answer 5

Taking measures the limit donor leukocyte contamination

Question 6

What is the treatment of Febrile nonhemolytic reaction?

Answer 6

Antipyretics

Question 7

The symptoms of Febrile nonhemolytic reaction are ____________ (short lived/long lasting)

Answer 7

short-lived (transient and minor)

Question 8

What are the two causes of allergic reactions due to transfusion?

Answer 8

IgA is absent in the recipient body but the donor has got IgA
Any allergen present in the donor’s blood and IgE of the recipient recognize it.

Question 9

Allergen induced reaction is called ___________ allergic reaction.

Answer 9

Urticarial allergic reaction

Question 10

What is the treatment given in allergic-induced transfusion reactions?

Answer 10

Antihistamines

Transfusion should NOT be discontinued

Question 11

Hemolytic reactions are divided into two types. Name them.

Answer 11

Acute hemolytic reaction

Delayed hemolytic reaction

Question 12

The acute hemolytic reaction is ______ (IgG/IgM) mediated.

Answer 12

IgM

Question 13

The delayed hemolytic reaction is ______ (IgG/IgM) mediated.

Answer 13

IgG

Question 14

_____ (ABO/Rh) incompatibility is an example of acute hemolytic reaction.

Answer 14

ABO

Question 15

_____ (ABO/Rh) incompatibility is an example of delayed hemolytic reaction.

Answer 15

Rh

Question 16

What are the other blood groups that can mediate the hemolytic reaction?

Answer 16

Kidd and Kell

Question 17

How does hemolysis occur in both types of hemolytic reactions?

Answer 17

It is complement-mediated hemolysis

Question 18

Type of hemolysis that occurs in acute hemolytic reaction is __________ (intravascular/extravascular)

Answer 18

intravascular

Question 19

On urine analysis, there _____ (is/is’nt) hemoglobinuria in hemolytic reaction

Answer 19

is

Question 20

Other lab findings include in hemolytic reaction
_________ (high/low) LDH
_________ (high/low) haptoglobin

Answer 20

high LDH

low haptoglobin

Question 21

________ hemolytic reactions are usually caused by preformed antibodies against donor red cells that fix complement.

Answer 21

Acute

Question 22

________ hemolytic reactions are caused by antibodies that recognize red cell antigens that the recipient was sensitized to previously

Answer 22

Delayed

Question 23

Give an example of a condition in which an acute hemolytic reaction can occur.

Answer 23

The patient receives ABO incompatible unit of blood by mistake

Question 24

Give an example of a condition in which a delayed hemolytic reaction can occur.

Answer 24

A prior blood transfusion and patient becomes sensitized to the antigen

Question 25

Direct Coombs test is _________ (positive/negative) in both hemolytic reactions.

Answer 25

positive

Question 26

What are the symptoms of hemolytic reaction?

Answer 26

Fever Chills Shaking Flank pain

Question 27

What can happen in severe cases of hemolytic reaction?

Answer 27

DIC Shock Acute renal failure Death

Question 28

Some antibodies do not fix complement in hemolytic reactions. Then, how does hemolysis occur in this type?

Answer 28

Red cell opsonization Extravascular hemolysis Spherocytosis (Minor signs and symptoms)

Question 29

What is TRALI acronym for?

Answer 29

Transfusion-Related Acute Lung Injury

Question 30

TRALI is a severe and frequently fatal complication in which factors in transfused blood trigger the activation of ____________ in the lung microvasculature.

Answer 30

neutrophils

Question 31

TRALI occurs _________ (more frequently/equally) in patients with preexisting lung disease.

Answer 31

more frequently

Question 32

Explain the two-hit hypothesis of TRALI.

Answer 32

The first hit is due to the priming event of neutrophils | The second hit is due to transfused blood

Question 33

What is the priming event of neutrophils in TRALI?

Answer 33

Increased sequestration and sensitization of neutrophils in the microvasculature of lungs. Inflammatory mediators may cause activation of the endothelium.

Question 34

How does transfused blood act as a second hit in TRALI?

Answer 34

The antibodies in the donor's blood recognize class I MHC molecules (antigens) on the recipient's neutrophils.

Question 35

On whom, the antibodies against neutrophils are most likely to be found in TRALI?

Answer 35

Multiparous women (because these women generate antibodies against the fetus)

Question 36

What kind of blood products have high levels of antibodies against neutrophils in TRALI?

Answer 36

Fresh frozen plasma and platelets

Question 37

What are the symptoms of TRALI?

Answer 37

Sudden respiratory failure Fever Hypotension Hypoxemia

Question 38

What are the treatment options and methods of prevention in TRALI?

Answer 38

Supportive treatment | Exclude multiparous women from plasma donation

Question 39

Most bacterial infections are caused by _____ flora in transfusion reactions.

Answer 39

skin

Question 40

Significant bacterial contamination is much more common in _________ (platelet/red cell) preparations

Answer 40

platelet

Question 41

Why is significant bacterial contamination much more common in platelet preparations?

Answer 41

Platelets must be stored at room temperature. That is also favorable for bacterial growth.

Question 42

What are the symptoms of infection-mediated transfusion reaction?

Answer 42

Fever Chills Hypotension

Question 43

What is the treatment of infection-mediated transfusion reaction?

Answer 43

Broad-spectrum antibiotics

Question 44

What are some examples of infection-mediated transfusion reaction?

Answer 44

``` HIV Hepatitis B and C West Nile virus Trypanosomiasis Babesiosis ```

Question 45

What are the rate of transmission of HIV Hepatitis C Hepatitis B

Answer 45

HIV - 1 in 2 million Hepatitis C 1 in 1 million Hepatitis B 1 in 500,000