Transfusion reactions

Question 1

If allergy

Answer 1

Ranges from urticaria to angioedema and anaphylaxis. Management: stop the transfusion, give saline, Adrenaline (if anaphylactic), Chlorphenamine, and Hydrocortisone.

Question 2

Acute haemolytic transfusion reaction

Answer 2

Early: fever, hypotension, and anxiety

Late: generalised bleeding secondary to disseminated intravascular coagulation (DIC)

Question 3

Febrile non-haemolytic transfusion reaction (features and management)

Answer 3

fever, rigors/chills, but patients are otherwise well. Management: slow the transfusion, give Paracetamol.

Question 4

Transfusion-related acute lung injury (features and management)

Answer 4

pulmonary oedema and can cause acute respiratory distress syndrome (ARDS). Management: stop transfusion, give saline, treat ARDS.

Question 5

Transfusion-associated circulatory overload

Answer 5

fluid overload. Management: slow transfusion, Furosemide.

Question 6

Delayed haemolytic transfusion reaction

Answer 6

exaggerated response to a foreign antigen the patient has been exposed to before. Patients present with jaundice, anaemia, and fever, usually day 5 post-transfusion.

Question 7

Transfusion-associated graft-versus-host disease

Answer 7

donor blood lymphocytes attacking the recipient’s body. Rare but high risk of mortality.

Question 8

When to STOP transfusion

Answer 8

• allergy/anaphylaxis
• Acute haemolytic transfusion reaction
• TRALI