Transfusion Reactions

Introduction To Transfusion Reactions

Blood transfusion is the process of transferring blood or blood components from one person (donor) to another (recipient). It can be life-saving in certain medical conditions but may also be associated with significant risks. Transfusion reactions, allergic reactions or the development of transfusion transmitted infections can occur as a result of transfusion. This article will discuss transfusion reactions, their diagnosis, management, and all related topics.

Types of Transfusion Reactions

Transfusion reactions can be classified as:

Immediate Type: Allergic or anaphylactic reactions from IgA immunity, Graft vs. Host disease (GvHD) due to alloimmunisation to white blood cells, and reactions from mismatched NAPA and Rh phenotypes.
Intermediate Type: Febrile reactions due to antibodies to donor leukocytes, anti-HPA, or antibody–antigen mismatches, Acute Hemolytic Transfusion Reactions.
Delayed Type: Bacterial contamination, Transfusion Related Acute Lung Injury (TRALI).

Signs and Symptoms of Transfusion Reactions

Symptoms associated with transfusion reactions can range from mild to severe. Common signs and symptoms include:

Fever, chills, and rigors
Hypotension, tachycardia
Myalgia, back pain, chest pain, and headache
Hives, itchy skin, and swelling
Cough, dyspnea, and pulmonary edema
Nausea, vomiting, and diarrhea
Hypoxia, cyanosis, and laryngeal edema
Jaundice, hemoglobinuria, and hematuria.

Diagnosis and Management of Transfusion Reactions

A regulator platelet differential and a complete blood count (CBC) should be obtained, as well as other tests as needed. Tests such as a blood film, a direct antiglobulin test (DAT), coagulation studies, and urinalysis may be necessary to rule out other conditions and causes of symptoms. Treatment of a transfusion reaction may involve administration of antihistamines or steroids. In severe cases, a fluid bolus or medication to treat hypotension may be necessary. In patients with GvHD, immunosuppressant drugs such as cyclosporine or azathioprine may be needed.

Prevention of Transfusion Reactions

To minimize the risk of reactions, donors should be screened and the blood should be tested for compatibility. Trans-fusions should be performed by experienced clinicians who are knowledgeable about blood product transfusion and who can recognize and treat a transfusion reaction. Transfusions should be performed in accordance with the local, national, and international guidelines.