Transfusion Reaction

Question 1

What are the acute types of a transfusion reaction?

Answer 1

1. Haemolytic
2. Allergic
3. Febrile non-haemolytic transfusion
4. Transfusion related to acute lung injury

Question 2

What is a haemolytic transfusion reaction usually caused be?

Answer 2

ABO red-cell incomp

Question 3

What sort of reaction is an allergic transfusion reaction?

Answer 3

hypersensitivity reactions

Question 4

What sort of reaction is a febrile non-haemolytic transfusion reaction?

Answer 4

immune mediated

Question 5

How does a transfusion reaction related to lung injury happen?

Answer 5

result of granulocyte activation in the pulmonary vasculature, resulting in increased vascular permeability

Question 6

What are examples of delayed transfusion reactions?

Answer 6

1. Delayed haemolytic transfusion reaction
2. Transfusion associated graft-versus-host disease
3. Post-transfusion purpura (preg)

Question 7

What are RF for a transfusion reaction?

Answer 7

1. ABO incompatibility
2. Pregnancy
3. Transfusion
4. Transplantation and immunocomprised status
5. IgA deficiency
6. Hx of transfusion reaction

Question 8

What are signs and symptoms of a transfusion reaction?

Answer 8

1. Chills
2. Flushing
3. Dyspnoea
4. Fever

Question 9

What are possible differential diagnosis for transfusion reaction?

Answer 9

1. Transfusion associated sepsis
2. Non-immune mediated haemolysis
3. Transfusion associated circulatory overload

Question 10

What are possible investigations for a transfusion reaction?

Answer 10

1. Direct antiglobulin test
2. Visual inspection of post-transfusion blood samples
3. Repeat ABO testing on post-transfusion blood sample
4. Post transfusion urinalysis

Question 11

What would a direct antiglobulin test show?

Answer 11

+ve with haemolytic

Question 12

What would a visual inspection of post transfusion bloods sample show?

Answer 12

can show haemolysis

Question 13

Why would you do a post transfusion urinalysis?

Answer 13

can show free haemoglobin which suggests acute haemolytic transfusion reaction

Question 14

What is management plan general for transfusion reaction?

Answer 14

stop transfusion or slow

Question 15

What else do you do if bacterial contamination?

Answer 15

start broad spectrum antibitoics

Question 16

What else do you do if non-haemolytic febrile transfusion reaction?

Answer 16

antipyretic and monitor

Question 17

What else do you do if allergic transfusion reaction?

Answer 17

1. (anaphylaxis): adrenaline

2. (no anaphylaxis): antihistamine chlorphernamine 10mg slow IV/IM

Question 18

What else do you do if fluid overload?

Answer 18

oxygen and diuretic e.g. furosemide 40mg IV

Question 19

What else do you do if TRALI?

Answer 19

give 100% O2

Question 20

What are possible complications of transfusion reactions?

Answer 20

1. Acute renal failure
2. Acute resp failure
3. Hypothermia
4. Thrombocytopenia
5. Iron overload
6. Anoxic brain injury
7. DIC
8. Death

Question 21

What is the prognosis of transfusion reactions?

Answer 21

1. Acute haemolytic transfusion reaction: 5% proceeds to death
2. TRALI: fatal