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transfusion reactions Flashcards

1
Q

could
cause transfusion reaction)

A

bacteria

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2
Q

Most cases there are reactions that would manifest as _____ as related to TRALI
and TACO

A

pulmonary edema

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3
Q

(most common sign of AHTR)

A

Fever (>1C rise above 37

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3
Q

Collection of information on the complications (donor related reactions and even transfusionassociated reaction) of transfusion and blood collection

A

HEMOVIGILANCE

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4
Q

hemovigilance factors

A

◦ Collection of transfusion reaction
◦ Analysis of data
◦ Improvements in preventing reactions

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4
Q

MAIN CAUSE OF AHTR

A

Severity is related to amount of incompatible blood transfused

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5
Q
  • Nationwide and international effort to track adverse reactions and improve transfusion practice of
    blood collection, blood transfusion, and even transfusion of stem cell tissues and organs in order
    to prevent certain cases of transfusion reactions
A

hemovigilance

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5
Q

what comes first hemologbinuria or hematuria in AHTR?

A

Hemoglobinuria
Hematuria

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6
Q

Accelerated destruction of transfused RBCs

A

ACUTE HEMOLYTIC TRANSFUSION REACTION (AHTR)

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7
Q

Antibody-mediated incompatibility it may be because of ABO or other blood group antibodies

A

ACUTE HEMOLYTIC TRANSFUSION REACTION (AHTR)

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8
Q

AHTR: DAT positive because of intervension of

A

gG and C3b that will promote destruction of RBCs

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8
Q

In AHTR acute kidney injury can be attributed to

A

DIC

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8
Q

Generally mild and self limiting

A

FEBRILE NONHEMOLYTIC TRANSFUSION REACTION (FNHTR)

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8
Q

poikilocyte seen in AHTR

A

spherocytes

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9
Q

in AHTR this is sign is because of the release of Hgb

A

Acute kidney injury

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9
Q

treatment in AHTR that decreases the tendecies for coagulopathy

A

Heparin Transfusion

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10
Q

Risk factors/ considerations
* Develops mostly in patients unable to report symptoms (unconscious, young, mute)
* Unconscious patients (ICU, surgery)
* ABO-mismatched platelet transfusions (“O” units to other AB types)

A

AHTR

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10
Q

Plasma and platelet transfusions – because of the high content of antibodies in these
units specially in type O units are transfused into A, B, or AB can lead to

A

AHTR

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11
Q

treatement for AHTR that promotes blood flow in glomerulus in the kidneys in order to promote
the production of urine

A

Furosemide

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12
Q

One of the most common adverse transfusion reaction

A

FEBRILE NONHEMOLYTIC TRANSFUSION REACTION (FNHTR)

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13
Q

Mimics other transfusion reactions (TRALI, AHTR, TACO, TAS) thus it is hard to diagnose

A

FEBRILE NONHEMOLYTIC TRANSFUSION REACTION (FNHTR)

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13
Q

Problem: leads to discontinuation, wastage of blood units and delay during subsequent
transfusion

A

FEBRILE NONHEMOLYTIC TRANSFUSION REACTION (FNHTR)

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14
Q

FNHTR is often caused by

A

Recipient anti-WBC antibodies, triggering cytokine release

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15
Q

blood units that gives high tendency for FNHTR

A

Blood units that are not leukoreduced

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15
Q

Administer antipyretics (acetaminophen (paracetamol)) – bring down fever; either IV or oral

A

FNHTR

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16
Q

what reaction? Fever (>100.4F or 38C); change of at least 1.8F (1.0C) within 4 hours

A

FEBRILE NONHEMOLYTIC TRANSFUSION REACTION (FNHTR)

16
Q

what reaction? Mild dyspnea or mild change breathing patterns

A

FEBRILE NONHEMOLYTIC TRANSFUSION REACTION (FNHTR)

17
Q

Incidence s much higher in hematology/oncology patients

A

FEBRILE NONHEMOLYTIC TRANSFUSION REACTION (FNHTR)

18
Q

Patients with Sickle Cell Disease
Chronic transfusion

A

FNHTR

18
Q

Antibodies against donor plasma protein

A

ATRs

19
Q

if hemolysis is detected in any of test for FNHTR, is he suffering from FNHTR or not

A

NOT suffering from FNHTR if there is hemolysis in test

19
Q

Symptoms start to manifest close to the end of transfusion; 5-10% do not appear 1-2 hours post
transfusion (somewhat delayed state)

A

FNHTR

19
Q

Anti-WBC antibody in FNHTR

A

Anti-human neutrophilic antigen antibody

20
Q

in FNHTR we do not use this for treatment

A

antihistamines, aspirin – may cause allergic reaction

Aspirin because there is no DIC symptoms

20
Q

Most common among platelet and plasma transfusions (2% of case); can happen in RBC
transfusion

A

ALLERGIC TRANSFUSION REACTIONS (ATRs)

21
Q

– to avoid FNHTR what blood unit should be used?

A

leukocyte-reduced units

22
Q

ATRS:
▪ Mild to moderate
▪ Symptoms limited to skin and GI tract

A

allergic

23
Q

ATRs:
▪ Moderately severe
▪ Involves mouth, throat – blockage of the airways – hard time breathing
▪ More serious GI tract symptoms, respiratory complaints

A

Anaphylactoid

24
Q

ATRs:
▪ Severe, life threatening; may lead to CPR administration because of lose of
consciousness
▪ Profound hypotension, shock

A

Anapylactic

25
Q

IgA deficiency with anti-IgA – often react with IgA transfused of the donor that would
lead to allergic anaphylactic reaction

A

ATRs

26
Q

What reaction associated with this
◦ Haptoglobins
◦ Complement (C4)
◦ Cytokines

A

ATRs

27
Q

ATR Mild reactions (cutaneous) treated by Mild reactions (cutaneous) treated by

A

diphenhydramine or antihistamines

28
Q

ATRs:
Severe urticarial, oropharyngeal or URT symptoms require what treatment

A

steroid treatment or epinephrine

29
Q

ATR: Oxygen and blood pressure regulation may be necessary for anaphylactoid and anaphylactic
reactions; nausea treatment?

A

Trendelenburg position

30
Q

in ATR the use of IgA-deficient units is often seen in ?

A

washed RBC units

31
Q

Leading cause of mortality of most blood transfusion ; adverse reactions to transfusion

A

TRANSFUSION-RELATED ACUTE LUNG INJURY (TRALI)

31
Q

Aggravated by the amount of plasma transfused

A

TRANSFUSION-RELATED ACUTE LUNG INJURY (TRALI)

32
Q

Main cause of TRALI:

A

presence of anti-WBC particularly donor anti-HNA and anti-HLA
antibodies

32
Q

Cytokines would activate endothelial cells to open or widen in order to neutrophils to
pass through the alveolar capillaries in order to promote leakage of fluids of (transudate
or exudates)

A

TRALI

33
Q

TRALI: Diagnosis includes chest x-rays wherein ____ can be seen

A

bilateral lung infiltration

33
Q

criteria are present but other causes of ALI is identified

A

Possible TRALI

33
Q

all criteria of TRALI identified but onset is within 6-72 hours post
transfusion

A

Delayed TRALI

33
Q

nvolves patient factors that would predisposed in certain person to a case of TRALI. It
involves that prime neutrophils or pulmonary endothelial cells that would activate cytokine
release that would affect the endothelial lining of alveolar capillaries that would result to
edema.

A

First hit; TRALI

33
Q

TRALI signs: because of anti-HNA reacting with patient neutrophils

A

Transient leukopenia

34
Q

t is related to the transfused product. Some factors are specific to a particular product
while other are common to all product as for the case of the presence of HLA or HNA in RBC
units.

A

Second hit

34
Q

is beneficial when diagnosing to TRALI

A

X-ray

34
Q

TRALI signs: caused by anti-HLA antibodies

A

Thrombocytopenia

35
Q

Subtle bilateral ‘white-out” appearance of CXR (Pulmonary edema)

A

TRALI

36
Q

Most frequent infection associated with transfusion

A

TRANSFUSION-ASSOCIATED SEPSIS (TAS); TRANSFUSION-TRANSMITTED BACTERIAL
INFECTION (TTBII)

37
Q

rbc units are invaded by what bacteria

A

Gram-negative rods; Enterobacteriaceae

38
Q

NOT HIV OR HEPA B BUT BACTERIAL INFECTION

A

TRANSFUSION-ASSOCIATED SEPSIS (TAS); TRANSFUSION-TRANSMITTED BACTERIAL
INFECTION (TTBII)

39
Q

platelet units are invaded by what bacteria

A

– Gram-positive cocci; normal skin microbiota; S. aureus

40
Q

– over contamination or population/ growth of bacteria in the circulation due to
multiple release of endotoxins

A

Septic shock

41
Q
  • Immunocompromised state
  • Low WBC counts
A

TRANSFUSION-ASSOCIATED SEPSIS (TAS); TRANSFUSION

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