Transfusion Reactions Flashcards
What are the categories of transfusion reactions?
Immunological - acute haemolytic, non-haemolytic febrile, allergic
Infective
Transfusion-related acute lung injury
Transfusion-associated circulatory overload
Other - hyperkalaemia, iron overload, clotting
What are the features and management for a non-haemolytic febrile reaction?
Fever, chills
Caused by:
Red cell transfusion (1-2%)
Platelet transfusion (10-30%)
Management:
Slow or stop the transfusion
Paracetamol
Monitor
What are the features and management for a minor allergic reaction?
Pruritus, urticaria
Management:
Temporarily stop the transfusion
Antihistamine
Monitor
What are the features and management for anaphylaxis?
Can be caused by patients with IgA deficiency who have anti-IgA antibodies
Hypotension, dyspnoea, wheezing, angioedema.
Management: Stop the transfusion IM adrenaline ABC support oxygen fluids
What are the features and management for acute haemolytic reaction?
ABO-incompatible blood e.g. secondary to human error
Fever, abdominal pain, hypotension
Management:
- Stop transfusion
- Confirm diagnosis
check the identity of patient/name on blood product
- send blood for direct Coombs test, repeat typing and cross-matching
- Supportive care
fluid resuscitation
What are the features and management for transfusion-associated circulatory overload (TACO)?
Excessive rate of transfusion, pre-existing heart failure
Pulmonary oedema, hypertension
Management:
Slow or stop transfusion
Consider intravenous loop diuretic (e.g. furosemide) and oxygen
What are the features and management for transfusion-related acute lung injury (TRALI)?
Hypoxia, pulmonary infiltrates on chest x-ray, fever, hypotension
Management:
Stop the transfusion
Oxygen and supportive care
What would cause an infective reaction to transfusion?
V rare
vCJD transmission
