Transfusion reaction: Difference between revisions

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====Acute hemolytic transfusion reactions====
====Acute hemolytic transfusion reactions====
ICD9: {{ICD9|999.6}}
ICD9: {{ICD9|999.6}}
Acute hemolytic transfusion reactions due to ABO incompatibility may show chills, fever, hypotension, renal failure, back pain, hemoglobinuria  
Acute hemolytic transfusion reactions due to ABO incompatibility may show chills, fever, <span style="background-color:fuschia">hypotension</span>, renal failure, back pain, hemoglobinuria  


====Delayed hemolytic transfusion reactions====
====Delayed hemolytic transfusion reactions====
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===Allergic reactions===
===Allergic reactions===
Type 1 hypersensitivity ([[immediate hypersensitivity]]) reactions include:
Type 1 hypersensitivity ([[immediate hypersensitivity]]) reactions include:
* [[Anaphylaxis|Anaphylactic]] transfusion reactions may occur, especially in patients with IgA-deficiency and may cause <span style="background-color:cyan">dyspnea</span>, bronchospasm, hypotension, urticaria.
* [[Anaphylaxis|Anaphylactic]] transfusion reactions may occur, especially in patients with IgA-deficiency and may cause <span style="background-color:cyan">dyspnea</span>, bronchospasm, <span style="background-color:fuschia">hypotension</span>, urticaria.
* [[Urticaria]] may occur due to the recipient's IgE reacting to antigens from the donor and cause urticaria, pruritis, and flushing.
* [[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)===
ICD9: {{ICD9|518.7}}
ICD9: {{ICD9|518.7}}
Transfusion-related acute lung injury (pulmonary leukoagglutinin reaction) (TRALI) is an acute reaction that may include <span style="background-color:cyan">dyspnea</span>, hypoxemia, respiratory failure, hypotension, and fever.
Transfusion-related acute lung injury (pulmonary leukoagglutinin reaction) (TRALI) is an acute reaction that may include <span style="background-color:cyan">dyspnea</span>, hypoxemia, respiratory failure, <span style="background-color:fuschia">hypotension</span>, and fever.


===Posttransfusion purpura===
===Posttransfusion purpura===
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===Other reactions===
===Other reactions===
* Air embolus may manifest 'sudden <span style="background-color:cyan">dyspnea</span>, cyanosis, chest pain, cough, hypotension, cardiac arrhythmia.'{{ICD9|999.1}}<ref name="pmid17381620">{{cite journal |author=Sanders RP, Geiger TL, Heddle N, Pui CH, Howard SC |title=A revised classification scheme for acute transfusion reactions |journal=Transfusion |volume=47 |issue=4 |pages=621–8 |year=2007 |month=April |pmid=17381620 |doi=10.1111/j.1537-2995.2007.01163.x |url=http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0041-1132&date=2007&volume=47&issue=4&spage=621 |issn=}}</ref>  
* Air embolus may manifest 'sudden <span style="background-color:cyan">dyspnea</span>, cyanosis, chest pain, cough, <span style="background-color:fuschia">hypotension</span>, cardiac arrhythmia.'{{ICD9|999.1}}<ref name="pmid17381620">{{cite journal |author=Sanders RP, Geiger TL, Heddle N, Pui CH, Howard SC |title=A revised classification scheme for acute transfusion reactions |journal=Transfusion |volume=47 |issue=4 |pages=621–8 |year=2007 |month=April |pmid=17381620 |doi=10.1111/j.1537-2995.2007.01163.x |url=http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0041-1132&date=2007&volume=47&issue=4&spage=621 |issn=}}</ref>  
* Hypothermia
* Hypothermia
* Circulatory overload may cause <span style="background-color:cyan">dyspnea</span>.
* Circulatory overload may cause <span style="background-color:cyan">dyspnea</span>.
* Hypotension associated with leukoreduced blood and maybe [[angiotensin-converting enzyme]] may cause flushing and hypotension.
* Hypotension associated with leukoreduced blood and maybe [[angiotensin-converting enzyme]] may cause flushing and <span style="background-color:fuschia">hypotension</span>.


==References==
==References==

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In medicine, a transfusion reaction is an adverse effect due to blood component transfusion such as erythrocyte transfusion or platelet transfusion.

A classification has been proposed by the American Association of Blood Banks (AABB).[1]

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

Type 1 hypersensitivity (immediate 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 dyspnea, hypoxemia, respiratory failure, hypotension, and fever.

Posttransfusion purpura

Posttransfusion purpura (PTP) is an immune thrombocytopenia. This is more common in women who have been pregnant.

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

999.39

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.'999.1

[1]

  • Hypothermia
  • Circulatory overload may cause dyspnea.
  • Hypotension associated with leukoreduced blood and maybe angiotensin-converting enzyme may cause flushing and hypotension.

References

External links