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Flashcards in Transfusion Reactions Deck (23)
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1

Most transfusion reactions occur within the first _____ minutes of the blood transfusion.

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2

Transfusion Reaction Classification

-Classification is based on ______ or ______

-Categories include ______ vs. ______ onset and ______ vs non-_____.

-Classification is based on time of onset or symptoms

-Categories include acute vs delayed onset and immunological vs non-immunological.

 

3

What are the symptoms of an allergic transfusion reaction?

 

4

Why do allergic transfusion reactions occur?

Can they you eventually complete the transfusion?

5

How do you prevent allergic transfusion reactions from occuring?

-In highly atopic people or those with previous ATRs, consider antihistamines

-If a patient has a history of ATR, transfuse slowly

6

What do you want to rule out with ATRs?

Rule out hemolysis

7

What are the symptoms of an acute hemolytic transfusion reaction (AHTR)?

-One of the most severe complications of transfusion therapy.

-Abs from recipient plasma reacts with donor RBCs

-symptoms occur due to donor cells agglutinate, blocking capillaries and obstructing blood flow to vital organs. Agglutinated cells are rapidly destroyed within hours

-Release of free Hb into plasma and urine. Hb can plug renal tubles --> disruption of nephron functioning and leads to renal failure.

8

Acute hemolytic transfusion reaction

  • Cause?
  • Prevention?
  • Treatment?

9

What are the symptoms of a delayed hemolytic transfusion reaction?

DHTR can occur in patients with low titers of antibodies against an RBC Ag.

  • Here, patient has an Ab following transfusion or pregnancy in the past but alloantibody waned to the point of no detection by current T&S
  • When exposed to another blood product, immune cells generate sufficient Abs to hemolyze the transfused RBCs.

10

DHTR

  • usual cause?
  • prevention?
  • treatment?

11

What are the symptoms of febrile non-hemolytic transfusion reaction?

  • Reactions noted by a rise of 1 C from baseline temperature and greater than 38 C. This may occur during transfusion or up to 4 hours post-transfusion
  • Reactions are typically associated with transfusion of cellular products (such as platelets or RBCs) which may contain WBC
  • May also be seen in leuko-depleted products due to presence of soluble cytokines

 

12

FNHTR

  • usual cause?
  • prevention?
  • treatment?

13

Symptoms of transfusion-associated circulatory overload?

Volume overload --> cardiogenic pulmonary edema

  • transfusion should be administered slowly particularly in pediatric patients, severe anemia, or CHF 

14

TACO

  • cause?
  • prevention?
  • treatment?

15

Symptoms of transfusion-related acute lung injury?

Acute lung injury that an occur up to 6 hours post-transfusion and thought to be caused by WBC antibodies in the donor (occasionally in recipient) or other WBC-activating agents in the components.

  • A form of lung injury but lung injury is almost always transient
  • pulmonary edema is noncardiogenic
  • additional signs and symptoms include transient leukopenia/neutropenia.

16

TRALI

  • cause?
  • prevention?
  • treatment?

17

What are the differences between TRALI vs TACO?

18

What are the symptoms of transfusion transmitted infection?

Reactions caused by contaminated blood products

  • bacterial contamination can be catastrophic if not recognized and treated quickly

19

Which are the offending agents in TTI? Which blood product is most at risk?

  • Gram-neg bacteria: Pseudomonas, Klebsiella, E.coli can lead to more severe infections. Gram-positive bacteria can also be involved.
  • Platelets because they are stored at room temperature

20

TTI

  • cause?
  • prevention?
  • treatment?

21

DDx for transfusion reactions

22

What should you do when there's a transfusion reaction (general)?

  • Stop transfusion
  • Vitals
  • Maintain IV access
  • verify blood products match patient
  • notify blood bank/transfusion medicine 
  • transfusion reaction panel
  • collect urine sample

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