Transfusions Reactions Flashcards
What is a diverse group of unfavorable transfusion related events that occur during or after transfusion of blood and blood components
Transfusion Reactions
What transfusion reactions occur with the transfusion of incompatible RBCs (most common) or plasma products that is immune mediated and results in intra or extravascular hemolysis
Hemolytic Transfusions reactions
What transfusion reaction is where the immune system is a common pathway but intra and extravascular hemolysis does not occur
Non-Hemolytic Transfusion Reaction
Immediate (acute) transfusion reaction occurs when?
during or within 24 hours of transfusion
Delayed transfusion reaction occurs when?
several days to weeks after transfusion
Name the 2 Hemolytic Reactions
- Acute Intravascular (ABO)
2. Delayed Extravascular (IgG Abs)
Name the 5 Immediate Non-Hemolytic Reactions
- Febrile
- Allergic/Anaphylactic
- TRALI
- TACO
- Bacterial
Name the 5 Delayed Non-Hemolytic Reactions
- Alloimmunization
- Post Transfusion Purpura
- Transfusion related GVHD
- Iron Overload
- Disease Transmission
Antibodies most associated with IHTRs and DHTRs
IHTRS: Intravascular-IgM (ABO)
DHTRS: Extravascular-IGG
Bedside procedures in the event of a suspected transfusion reaction (8)
- Stop transfusion
- Clerical Check
- Call MD
- Call BB
- Draw EDT
- Send EDTA, donor bag, tubing paperwork and order to BB
- Send 1st UA if AHTR suspected
- Keep IV lines open
Describe steps to follow in a lab investigation of a suspected transfusion reaction
- Clerical check and attached solution
- centrifuge post-transfusion sample to assess for visual hemoglobinemia (Compare to pre-transfusion sample)
- DAT perfomred on post tansfusion EDTA sample
- Additional workup based on results of the above 3 items AND clinical symptoms of patient
- Perform DAT
- If >2C temp rise, send bag to micro for culture
Why will a DAT be either positive or negative in an acute HTR?
Negative if there is not an antibody antigen reaction and positive if there is!
What is the characteristic appearance of the DAT when an acute or delayed HRT transfusion reaction has occurred
Positive/hemolyzed
Explain why a IAT on a post-reaction serum sample may be negative following the infusion of antigen positive blood to an individual with corresponding antibody
*
Most common transfusion-associated disease
Hepatitis
If a patient should come down with Hepatitiis or HIV suspected to be due to blood transfusion, the hospital should follow a reporting process. Hospital > notifies Blood center > notifies donor > gets retested > and Blood center > notifies hospital of results > notifies other facilities that used products
Look-back process
Most common cause of preventable hemolytic transfusion reaction
Clerical
What two tests are diagnostic for a transfusion reaction?
- DAT
2. Visual Hemoglobin
Definition
- abnormally rapid heart rate
Tachycardia
Definition
- Shortness of breath (SOB)
Dyspnea
Define
- FNHTR
Febrile Non-Hemolytic Transfusion Reaction
Define
- TRALI
Transfusion Related Acute Lung Injury
Define
- TACO
Transfusion Associated Circulatory Overload
Define
- PTP
Post-Transfusion (Thrombocytopenic) Purpura
Define
- TA-GVHD
Transfusion Associated Graft Versus Host Disease
Definition
- a rash of round, red welts on the skin that itch intensely, sometimes with dangerous swelling, caused by an allergic reaction, typically to specific foods.
Urticaria
Definition
- unpleasant sensation of the skin that provokes the urge to scratch. It is a characteristic feature of many skin diseases and an unusual sign of some systemic diseases
Pruritis
Definition
- superficial reddening of the skin, usually in patches, as a result of injury or irritation causing dilatation of the blood capillaries
Erythema
Definition
- an immune response generated in an individual or strain of one species by an alloantigen from a different individual or strain of the same species
Alloimmunization
Definition
- accumulation of iron in the liver and/or heart but also endocrine organs, in patients who receive frequent blood transfusions (such as those with thalassemia, sickle cell disease, aplastic anemia or myelodysplastic syndrome).
Transfusion Hemosiderosis
Definition
- “White-out” caused by changes in permeability of the pulmonary capillary membrane as a result of either a direct or an indirect pathologic insult
Noncardiogenic Pulmonary Edema
Definition
- condition that occurs due to a rapid transfusion of a large volume of blood
Circulatory Overload
