Transfusion Reactions

Question 1

Acute reactions

Answer 1

• Acute hemolytic
• Febrile nonhemolytic
• simple allergic
• severe allergic/anapylactic
• TACO
• TRALI
• sepsis

Question 2

Delayed reactions

Answer 2

• delayed hemolytic (immune-mediated)
• alloimmunization to RBC Ag
• transfusion-associated graft-vs-host disease
• transfusion-transmitted diseases

Question 3

Acute hemolytic TR

Answer 3

• during transfusion (within minutes)

- up to 4h post-transfusion

Question 4

Febrile nonhemolytic TR

Answer 4

• during transfusion or up to 4-6 h post-transfusion (relatively common)

Question 5

Simple allergic TR

Answer 5

• During transfusion or up to few hours post (very common 1:3-1:300)

Question 6

Severe allergic/anaphylactic TR

Answer 6

• usually during transfusion (within min)

Question 7

TACO

Answer 7

• during transfusion or up to a few hours post

- commons (1:100) - higher is susceptible pt (CHF)

Question 8

TRALI

Answer 8

• during and up to 6 h post

- not as common 1:5000

Question 9

sepsis

Answer 9

• usually during or within an hr post

Question 10

Delayed hemolytic TR

Answer 10

• 3 d - 2 or more weeks post transfusion

Question 11

Alloimmunization to RBC Ag

Answer 11

• IgM response - 10d - 2wks post
• IgG response - 3 or more wks post
• relatively common

Question 12

Transfusion-associated GVHD

Answer 12

• 2-30d post (most commonly within 4-10d post)

- mortality virtually 100%

Question 13

Transfusion transmitted dx

Answer 13

• days to years post

- HIV, HCV, HBV

Question 14

Treatment/Management

Answer 14

• STOP transfusion
• confirm correct blood product given
• abx for sepsis symptoms
• diuretics for volume overload
• transfer to ICU for TRALI