Last reviewed: 10 Oct 2022 Show
Last updated: 07 Jun 2019 SummaryPrompt recognition of an immune-mediated transfusion reaction is fundamental to improving patient outcome. Immune-mediated transfusion reactions can be classified as acute or delayed. Acute reactions occur within 24 hours of transfusion and include acute hemolytic, febrile nonhemolytic, allergic, and transfusion-related acute lung injury (TRALI). Delayed reactions occur days to weeks after the transfusion and include delayed hemolytic transfusion reactions, transfusion-associated graft-versus-host disease, and post-transfusion purpura. Although infrequent, nonimmune transfusion reactions, including hemolysis, transfusion-associated sepsis, and circulatory overload, should be considered in the differential diagnosis. Acute hemolytic transfusion reactions are most often the result of clerical error. Identification is critical because of the high probability of a second patient receiving the wrong blood product at the same time. Treatment depends upon the type of transfusion reaction. Although pretransfusion prophylactic acetaminophen and diphenhydramine are often routinely administered, there is little evidence to support this practice. DefinitionThis topic will mainly address immune-mediated transfusion reactions, which comprise an array of distinct adverse clinical responses to transfusion. They are mediated by the interaction of recipient antibodies to foreign antigens contained in any allogeneic blood products. Acute immune-mediated transfusion reactions occur immediately following, or within 24 hours of, transfusion. They include acute hemolytic, febrile nonhemolytic, allergic (with or without anaphylaxis), and transfusion-related acute lung injury (TRALI). Delayed immune-mediated transfusion reactions occur within days to weeks of transfusion and include delayed hemolytic transfusion reaction, graft-versus-host disease, and post-transfusion purpura. History and examKey diagnostic factors
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More investigations to consider Treatment algorithmacute transfusion reactiondelayed transfusion reactionContributorsAuthorsJordan A. Weinberg, MD, FACSAssociate Professor of Surgery Creighton University School of Medicine St. Joseph’s Hospital and Medical Center Phoenix AZ DisclosuresJAW declares that he has no competing interests. Peer reviewersChristoph Pechlaner, MDAssociate Professor of Medicine Innsbruck Medical University Innsbruck Austria DisclosuresCP declares that he has no competing interests. Marisa Marques, MDProfessor of Pathology University of Alabama at Birmingham Hospital Birmingham AL DisclosuresMM declares that she has no competing interests.
Why can a transfusion reaction be fatal?Causes of fatal transfusion reactions: Misidentification of patient Mislabeling of blood samples Errors in blood bank records Mistakes in blood typing Inaccurate antibody screening or crossmatching. Hemolytic. red cells are destroyed due to immune response or physical/chemical change.
What are the adverse effects of blood transfusion?
What causes major transfusion reactions?Causes of Transfusion Reactions. Transfusion reactions may be caused by the incompatibility between your blood and your donor's blood. These types of reactions are known as immune-mediated ...
How to treat transfusion reaction?When an urticarial transfusion reaction occurs:
What causes haemolytic transfusion reaction?A hemolytic transfusion reaction is a serious complication that can occur after a blood transfusion. The reaction occurs when the red blood cells that were given during the transfusion are destroyed by the person's immune system.
What is the most common cause of acute hemolytic transfusion reactions?Acute HTRs occurring during or within 24 h after administration of a blood product are usually caused by transfusion of incompatible red blood cells (RBCs), and, more rarely, of a large volume of incompatible plasma. Delayed HTRs are caused by a secondary immune response to an antigen on the donor's RBCs.
What is the most common cause of transfusion reactions?The most common cause for a major hemolytic transfusion reaction is a clerical error, such as a mislabelled specimen sent to the blood bank, or not properly identifying the patient to whom you are giving the blood.
Which antibody is associated with hemolytic transfusion reactions?Hemolytic transfusion reactions have been reported to be caused by antibodies with varying specificities, including anti-c, anti-E, anti-Fy3, anti-Fya, anti-Fyb, anti-Jka, anti-Jkb, anti-K, anti-Kpa, anti-M, anti-N, anti-s and anti-U antibodies [13, 14].
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Hemolytic transfusion reactions are often the result of
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