Transfusion and Transplant Reactions

Question 1

Allergic/ Anaphylactic Transfusion Reaction

Answer 1

TYPE I

Against proteins in transfused blood

Fever, wheezing, itchy, hypotension, resp arrest

minutes to hrs

Question 2

Febrile Nonhemolytic Transfusion Reaction

Answer 2

TYPE II

Host antibodies attack donor HLA and WBCs (not RBCs)

Fever, headache, chills, flushing

1-6 hrs

Question 3

Acute Hemolytic Transfusion Reaction

Answer 3

TYPE II

RBC destruction by antibodies due to …

ABO incompatibility OR host attacking antigen on donor RBC

Fever, hypotension, tachypnea, tachy, flank pain, hemoglobinuria or jaundice

w/in 1 hr

Question 4

Transfusion-Related Acute Lung Injury

Answer 4

Donor has antibodies against host neutrophils and pulmonary endothelial cells

Resp distress, pulmonary edema

w/in 6 hrs

Question 5

Hyperacute Transplant Rejection

Answer 5

TYPE II

Pre-existing antibodies in host against graft

Thrombosis of graft vessels –> ischemia (remove)

w/in min

Question 6

Acute Transplant Rejection

Answer 6

TYPE IV

CD8+ T cell reaction against graft MHC + humoral (develop antibodies to graft but not pre-existing)

wks to months

Question 7

Chronic Transplant Rejection

Answer 7

TYPE II and IV

CD4+ mediated (APCs present graft to them) –> cytokine release (both humoral and cytotoxic effects) –> vascular smooth muscle proliferation, atrophy, fibrosis and arteriosclerosis

Organ specific

Mo to yrs

Question 8

Graft v Host Disease

Answer 8

TYPE IV

Graft T cells attack host cells leading to organ dysfunction

More common in grafts w/ many T cells (bone marrow or liver transplant)

**Wanted in bone marrow transplant for leukemia (want to attack tumor)