Transfusion Rxns Flashcards
Acute Immunologic Rxn
Hemolytic Febrile Allergic Anaphylaxis TRALI
Hemolytic TxRx
Acute, immunologic
ABO incompatible, Cā activating antibodies
Onset in minutes, causes intravascular hemolysis
Fever, chills, oliguria, anuria, renal failure, hypotension, DIC
Free Hgb in the serum and urine
DAT positive
Treat by giving ABO compatible blood
Febrile TxRx
Acute, immunologic Recipient Abs to donor leukocyte antigens Increase in recipient temp >1.0C Non hemolytic DAT negative Give leukocyte reduced blood
Allergic TxRx
Acute, immunologic Cutaneous hypersensitivity Recipient Ab to donor plasma proteins Rash and hives DAT negative Pretreat with anti-histamines
Anaphylaxis TxRx
Acute, immunologic
Recipient Ab to donor plasma proteins
Includes IgA, haptoglobin, C4
Sudden onset, burning at site, coughing, SOB, bronchospasm
Leads to cyanosis, nausea, vomiting, severe cramps, diarrhea
Hypotension can lead to shock, loss of consciousness, death
DAT negative
Transfuse washed blood components to remove plasma
TRALI
Acute, immunologic
Donor antibodies to HLA antigens/neutrophil antigens of the recipient
Acute respiratory insufficiency, bilateral pulmonary edema
Chills, fever, cough, cyanosis, hypotension, SOB
DAT negative
Plasma containing components from the donor should not be used in the future
Acute Non-Immunologic
TACO
Hypocalcemia
Hypothermia
Air embolism
TACO
Acute, non-immunologic
Rapid increase in blood volume to patient with compromised cardiac/pulmonary status
Dyspnea, cyanosis, severe headache, hypertension, CHF
DAT negative
Stop infusion and place patient in sitting position
Hypocalcemia
Acute, non-immunologic
Excess citrate from when plasma/plt are transfused too fast or the person has impaired liver function
Facial tingling, nausea, vomiting
Slow or stop infusion
Hypothermia
Acute, non-immunologic
Drop in core body temp due to rapid infusion of large volumes of cold blood
Decrease in body temp and ventricular arrhythmias
Happens in small infants and during massive transfusions
Reduce rate of infusion or use blood warmers
Air Embolism
Acute, non-immunologic
If blood in an open system is infused under pressure or air enters the system
Chest pain, heart failure, confusion, hypotension
Place patient on left side with head down to displace air bubble from the pulmonic valve
Delayed Immunologic TxRx
Hemolytic
Graft vs Host disease
Post Txn Purpura
Hemolytic (Delayed)
Delayed, immunologic Onset within days Drop in Hgb/Hct after transfusion, weakness, pallor DAT positive, IAT repeat positive Give antigen-negative blood
Graft vs Host Disease
Delayed, immunologic
Donor T lymphocytes attack recipient tissues
Fever, dermatitis, erythroderma, hepatitis, diarrhea, pancytopenia
Irradiate blood products
Post Txn Purpura
Recipient antibodies to platelet antigens cause abrupt onset of severe thrombocytopenia
Purpura bleeding, fall in Plt count
Give high dose IVIG
