Transfusion Reactions Flashcards
Acute Hemolytic Transfusion Reaction (ABO incompatibility)
<10 mins post transfusion
fever, HoTN, flank pain, reddish urine, pain at infusion site
+ DAT, + hemolytic labs, hemoglobinuria
Febrile Non-Hemolytic Transfusion Reaction
0-6 hrs post transfusion
fever
exclude ABO incompatibility
prevented by leukoreduction
Simple Allergic Transfusion Reaction
< 10 mins
Severe Allergic or Anaphylactic Transfusion Reaction
< 10 mins
major risk: IgA def.
Transfusion Associated Circulatory Overload (TACO)
0-6 hrs post transfusion
hypoxia, JVD, pulmonary edema, elevated BNP
Transfusion Related Acute Lung Injury (TRALI)
0-6 hrs post transfusion
ARDS picture
due to donor antibodies to recipient PMNs
Delayed Hemolytic Transfusion Reaction (immune-mediated)
2 d to 4 wks
delayed drop in Hgb, + hemolytic labs, fever
fatigue, pallor, jaundice
- repeat type and screen to identify previously undetected Ab to minor Ag (Kell, Kidd, Duffy)
Alloimmunization to RBC Antigens
IgM response 10 d to 2 wks
IgG response > 3 wks
Transfusion Associated Graft vs Host Disease
4-30 days post transfusion
fever, maculopopular rash, diarrhea, pancytopenia
prevented by irradiation
risk factors: immunodeficiency, leukemia
Transfusion Transmitted Diseases
Days to Years post transfusion
Sepsis
0-6 hrs post transfusion
skin flora, GNR
leukoreduced/leukocyte filtration
- removes donor-derived cytokines that react with recipient antibodies out of donor cells
- prevents FNHTR
irradiated PRBC
- prevents transfusion-associated GVHD
- so is indicated in those at risk, including:
- immunodeficiencies
- hematological malignancy
- s/p allo BMT for aplastic anemia
Washed RBC
hx of urticarial rxns and allergy
especially IgA deficiency
