Transfusion reaction: Difference between revisions

From Citizendium
Jump to navigation Jump to search
imported>Robert Badgett
No edit summary
imported>Robert Badgett
Line 19: Line 19:
===Allergic reactions===
===Allergic reactions===
[[Hypersensitivity]] reactions include:
[[Hypersensitivity]] reactions include:
* Anaphylactic transfusion reactions may occur, especially in patients with IgA-deficiency.
* Anaphylactic transfusion reactions may occur, especially in patients with IgA-deficiency and may cause dyspnea, bronchospasm, hypotension, urticaria.
* Urticaria may occur due to the recipient's IgE reacting to antigens from the donor.
* Urticaria may occur due to the recipient's IgE reacting to antigens from the donor and cause urticaria, pruritis, and flushing.


===Transfusion related acute lung injury (TRALI)===
===Transfusion related acute lung injury (TRALI)===

Revision as of 20:41, 6 November 2008

This article is a stub and thus not approved.
Main Article
Discussion
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
 
This editable Main Article is under development and subject to a disclaimer.

A classification has been proposed by the American Association of Blood Banks (AABB).[1] In addition, the classification below is based on ICD9.

Immunologic

Febrile, nonhemolytic transfusion reaction (FNHTR)

FNHTR may include temperature elevation > 1°C, chills and/or rigors, headache, vomiting. This is a minor, acute reaction suggested by negative a Coombs' test, no free hemoglobin in the plasma, and no hemoglobin in the urine.

Hemolytic reactions

Hemolytic reactions due to blood group incompatibility is "mismatch between donor and recipient blood. Antibodies present in the recipient's serum are directed against antigens in the donor product. Such a mismatch may result in a transfusion reaction in which, for example, donor blood is hemolyzed."[2]

Acute hemolytic transfusion reactions

ICD9: 999.6

Acute hemolytic transfusion reactions due to ABO incompatibility may show chills, fever, hypotension, renal failure, back pain, hemoglobinuria

Delayed hemolytic transfusion reactions

ICD9: 999.7

This reaction usually causes delayed hemolysis. This may be caused by Rh incompatibility.

Allergic reactions

Hypersensitivity reactions include:

  • Anaphylactic transfusion reactions may occur, especially in patients with IgA-deficiency and may cause dyspnea, bronchospasm, hypotension, urticaria.
  • Urticaria may occur due to the recipient's IgE reacting to antigens from the donor and cause urticaria, pruritis, and flushing.

Transfusion related acute lung injury (TRALI)

ICD9: 518.7

Transfusion-related acute lung injury (pulmonary leukoagglutinin reaction) (TRALI) is an acute reaction that may include hypoxemia, respiratory failure, hypotension, and fever.

Graft-versus-host disease

Transfusion associated graft-versus-host disease (TA-GVHD) is when the donor's blood attacks the recipient's body.

Nonimmunologic

Nonimmune hemolysis

Nonimmune hemolysis may be due to physical destruction of donor blood from heating or freezing.

Chemical reactions

  • Hemosiderosis
  • Hypocalcemia from citrate toxicity
  • Hyperkalemia
  • Metabolic alkalosis and hypokalemia due to citrate

Transmission of infection

Transfusion associated sepsis may manifest 'fever > 40°C and/or cardiovascular collapse.'[1]

Other reactions

  • Air embolus may manifest 'sudden dyspnea, cyanosis, chest pain, cough, hypotension, cardiac arrhythmia.'[1]
  • Hypothermia
  • Circulatory overload
  • Hypotension associated with leukoreduced blood and angiotensin-converting enzyme may cause flushing and hypotension.

References

External links