Transfusion reaction: Difference between revisions

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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).<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>
==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. [[Antibody|Antibodies]] present in the recipient's serum are directed against [[antigen]]s in the donor product. Such a mismatch may result in a transfusion reaction in which, for example, donor blood is hemolyzed."<ref>{{MeSH|Blood group incompatibility}}</ref>
====Acute hemolytic transfusion reactions====
ICD9: {{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: {{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:
* [[Anaphylaxis|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: {{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.
===Posttransfusion purpura===
===Posttransfusion purpura===
Posttransfusion purpura (PTP) is an [[immune thrombocytopenia]]. This is more common in women who have been pregnant.
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===
{{ICD9|999.39}}
Transfusion associated sepsis may manifest 'fever > 40°C and/or cardiovascular collapse.'<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>
===Other reactions===
* Air embolus may manifest 'sudden dyspnea, 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>
* Hypothermia
* Circulatory overload may cause dyspnea.
* Hypotension associated with leukoreduced blood and [[angiotensin-converting enzyme]] may cause flushing and hypotension.
==References==
<references/>
==External links==
* [http://www.isbt-web.org/ International Society of Blood Transfusion (ISBT)]
* Dean L. (2005) [http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=rbcantigen Blood Groups and Red Cell Antigens] NCBI
** [http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=rbcantigen&part=ch3 Blood transfusions and the immune system]

Revision as of 22:17, 6 November 2008

Posttransfusion purpura

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

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