Transfusion reaction

Recipient antibodies to donor WBC

• Cytokines accumulated
• during storage

• Fever (>1C or 2F) with or without chills. (Can occur at
• beginning or 1—2 hrs after transfusion.

Nausea/vomiting

HTN

Tachycardia or Tachypnea

1.     Discontinue transfusion

2.     Report reaction

• Symptomatic treatment or
• none

• Uticaria, hives, itching, nausea, coughing, wheezing, respiratory
• distress, diarrhea, or vascular instability.

• 1.     Recipient antibody to plasma proteins – increased amount of
• units given.

Possible IgA deficiency

For mild case:

- Interrupt transfusion,

- Administer antihistamines,

- May continue transfusion.

• More severe cases: may
• require corticosteroids

1.     Acute respiratory distress:

•      a: dyspnea, &
• fever

•      b: Bilateral
• pulmonary edema

•      c: Cyanosis &
• severe hypoxemia (pO2 30-50 mm Hg & O2 <90%

•      2:  
• Hypotension (unresponsive to fluid admin.)

1: Donor HLA or neutrophil ABS

•       2: Two stage injury: Primed neutrophils
• secondary to lung trauma or infection then transfusion of biologically active
• lipids

1.     Stop Transfusion

• 2.     Supportive therapy may be necessary: Intubation, O2,
• or Mechanical ventilation.

• Improves within 48-96
• hours.

• 1.     Fever >3C above baseline
• 2.     Chills
• 3.     Tachycardia
• 4.     Hypotension
• 5.     Nausea/vomiting
• 6.     SOB
• Back Pain

Bacterial contamination

1.     Stop Transfusion

2.     Send units to lab

• A: Examine for discoloration, bubbles, plt clumping, culture
• & gram stain sample form unit.

• 3.     Blood Cultures from pt. (cultures from unit and pt. should both
• have organism.)

• Supportive pt care (may
• need antibiotics.

• 1.     Respiratory distress
• 2.     Hypoxemia
• 3.     Headache
• 4.     Cough
• 5.     Chest tightness
• 6.     HTN
• 7.     Jugular vein distension
• 8.     Increased Central venous pressure 
• 9.     Increased pulmonary wedge
• pressure.

• The patient’s cardiovascular system cannot handle the additional
• workload, therefore causing CHF.

• 1.     Stop transfusion
• 2.     Treat for CHF
• 3.     Lab Test: BNP is increased
• 4.     Put patient in Upright posture
• 5.     Give O2
• Diuresis

• 1.     Rash
• 2.     Fever
• 3.     Diarrhea

• 1.     HLA antigen difference between donor and recipient
• 2.     Presence of donor immunocompetent cells in recipient
• 3.     Recipient incapable of
• rejecting the blood component

1.     No Treatment Available. Patient mortality is high.

• Preventions: is to provide
• gamma irradiation products, crossmatch platelets and granulocytes, HLA match