Transfusion Reaction - Haemolytic Blood Group Antibodies

Question 1

What is the difference between intravascular and extravascular?

Answer 1

Intravascular: Complement Mediated rupture of sensitized RBC
Extravascular: Macrophage ingest sensitized RBC

Question 2

Describe the pathophysiology of Intravascular Haemolytic Transfusion Reaction

Answer 2

Antigen and Antibody complexes activate complement cascade and with high IgM and IgG titre
Haemolysed RBC

Question 3

What antibodies commonly cause instravascular reaction?

Answer 3

ABO antibodies, anti-P, PI, Pk, anti-Vel

Question 4

What are the symptoms symptoms of Intravascular reactions?

Answer 4

1. Fever and chills
2. Burning sensation at site of infusion
3. Chest restriction, tachycardia
4. Hypotension , shoc,
5. Lower back pain, nausea, vomiting
6. Feeling of impending doom
7. Hemoglobinuria
8. Bleeding due to DIC

Question 5

What are the major complications of Intravsacular reactions

Answer 5

1. Renal failure
2. Disseminated Intravascukar Coagulation
3. Fatal in 10% of ABO incompatibilities

Question 6

Define Disseminated Intravascular Coagulation

Answer 6

Inappropriate excessive and uncontrolled activation of haemostatic process

Question 7

How to manage Intravscular Reactions

Answer 7

1. Stop transfusion
2. Check recipienr identity against blood bag
3. Maintain blood pressure and treat shock with IV saline
4. Diuretic
5. Transfusion Reaction investigation

Question 8

Describe the pathophysiology of Extravascular reactions

Answer 8

RBCs sensitized with IgG and/or C3
Antigen Antibody complex forms
Macrophages phagocytoses sensitized RBCs

Question 9

List symptoms of Extravascular reactions

Answer 9

1. Fever and chills
2. Bilirubin in plasma and urine
3. Not fatal

Question 10

What are the complications of Extravascular reactions

Answer 10

1. Anemia

2. Jaundice

Question 11

What antibodies are associated with Extravascular reactions

Answer 11

IgG antibodies of:
Rh system
Kell system
Duffy system
Kidd system

Question 12

Describe the pathophysiology of delayed haemolytic transfusion Reaction

Answer 12

Patient has Antibody at undetectable level
Antibody Screening is negative
Compatible blood
Patient has secondary immune response to an antigen from transfusion

Question 13

List the symptoms of Delayed reaction

Answer 13

1. fever and chills.
2. Bilirubin in urine and plasma
3. Occurs 24 hours to 28 days later

Question 14

What antibodies are associated with Delayed reaction

Answer 14

1. C, c, E

2. Kidd antibodies

Question 15

What procedure is done if transfusion Reaction is detected ?

Answer 15

1. Pre transfusion sample
2. Post transfusion sample
3. Remains of transfusion unit
   A. Clerical checks
   B. Visual checks
   C. ABO and RhD
   D. Antibody Screening and panel
   E. Iat crossmatch
   F. DAT
   G. Eluate if DAT positive

Question 16

Define Transfusion Reaction

Answer 16

Adverse outcome from a transfusion of blood or blood product

Question 17

Draw a diagram of the haemolytic blood group Antibody

Answer 17

Haemolytic Transfusion Reaction
1. Intravascular (ABO) 2. Extravascular (Rh)
A. Immediate A. Immediate B. Delayed