Transfusion Complications

Question 1

What is the most common complication with transfusions?

Answer 1

febrile nonhemolytic reaction:

• fever, chills, dyspnea
• inflammatory mediators from donor lymphocytes
• can be delayed respone up to 6 hours

Question 2

What allergic reactions are associated with blood transfusion?

Answer 2

Severe lifethreatening reaction:

• rare (1 in 20,000-50,000)
• IgG mediated

Urticarial reactions:

• allergen in donor blood
• IgE mediated

Question 3

What acute hemolytic reactions occur as complications with transfusion?

Answer 3

ABO incompatability:

• preformed IgM/complement mediated intravascular hemolysis
• no previous sensitazation required (preformed Abs)
• rapid onset fever, chills, flank pain _{(rapidness differentiates from febrile nonhemolytic?)}
• can progress to DIC, shock, acute renal failure, or death

Question 4

What delayed hemolytic reactions occur as complications with transfusion?

Answer 4

Minor blood group (non-ABO) incompatability:

• IgG/complement mediated intravascular hemolysis
• previous sensitazation required
• against Rh, Kell, Kidd
• delayed onset fever, chills, flank pain

Question 5

What is TRALI?

Answer 5

Transfusion-Related Acute Lung Injury

• activation of primed neutrophils in the lung
• primed in the setting of lung disease
• donor Ab that recognizes recipient MHC
• sudden onset respiratory failure with bilateral infiltrates

-fever, hypotension, hypoxemia

Question 6

What complications occur in those who receive chronic blood transfusion?

How is this addressed?

Answer 6

Development of antibodies to minor blood group types (outside of ABO/Rh) such as Kell, Duffy, and Kidd.

Should try to recieve blood from as genetically similar of a donor pool as possible