Acute HTR FNHTR Allergic reaction Anaphylaxis reaction TRALI

Definition Destruction of RBC in the Fibrile Non Hemolytic Reaction occurs within TRALI is the severe fatal
recipient due to immunologic Transfusion Reaction is most minutes of beginning transfusion reaction
incompatibility between the frequent adverse reaction. transfusion. which the lungs fills
donor’s blood and the recipient. Life threatening!! with a high protein fluid
Causes 1. ABO incompatibility HLA/Leukocyte Ag on the WBC Caused by Ab recipient to Associated with IgA Ab Caused by donor AB
2. Complement activation of the donor that react with the plasma proteins donor that react with the
by IgM (within 24 hrs) recipient Ab recipient’s
granulocytes/vice versa
Symptoms 1. Fever 1. Fever 1. Urticarial reaction 1. No fever 1. Dyspnea
2. Chills 2. Chills with fever -hives 2. Skin flushing 2. Cyanosis
3. Acute renal failure 3. Shaking -itching 3. Nausea 3. Tachycardia
4. Dissemenated 2. Erythema 4. Diarrhea 4. Hypoxemia
Intavascular -redness of the 5. Hypotension *Diagnosis of X-ray of
Coagulataion skin 6. Cardiac acute respiratory
5. Hypotension 3. Dyspnea arrhythmia insufficiency shows:
6. Irreversible shock -shortness of the 7. Cardiac arrest Bilateral symmetric
7. Early signs: breath 8. Laryngeal edema pulmonary edema
-Anxiety
-Pain at infusion site *Onset of symptoms is
-Back/chest pain SUDDEN
Prevention 1. Renal failure 1. Antipyretics Antihistamine can be 1. Wash blood 1. IV steroids
-fluids(saline) are infused -to treat fever/ as a given prior to transfusion components to 2. Avoid donation
along with preventive measure. or during transfusion remove plasma from:
diuretics(furosemide) to 2. Aspirin NOT USED 2. Epinephrine -multiparous
increase urine output because it can effect on (Vasoconstrictor women
2. Follow the SOP to avoid platelet function. & bronchiole -who have
errors 3. Leukocyte reduction by: dilator) receive multiple
3. Perform pretransfusion -Centrifugation (buffy transfusions
compatibility testing coat poor)
-Filtration (prestorage&
post storage)
RufaidaMuhammad
 Bacterial Contamination Circulatory Overload
Definition Does not involve antigen-antibody interactions Occurs when a patients is transfused too rapidly which cause the
cardiopulmonary system overloading (too much fluid at one time)
Causes Bacterial contamination of blood products: Transfused the blood rapidly which cause cardiopulmonary system
1. Yersinia enterocolitica overloading (too much fluid at one time).
2. Serratia liquifaciens

Ways of blood contamination with bacteria:

1. Unsterile container due to improper manufacturing
2. Donor’s skin or blood
3. From the outside during collection, preparation or storage
4. Before infusion
Symptoms 1. Fever 1. Cyanosis
2. Shock 2. Dyspnea
3. Renal dysfunction (due to endotoxins) 3. Severe headache
4. Nausea 4. Congestive heart failure (CHF)
5. Vomitting
Prevention 1. Gram stain & blood cultures must be done 1. Place patient in upright position
2. Broad-spectrum antibiotics should be given immediately 2. Give patients small aliquots of each unit over time
intravenously -to prevent reaction
3. Miantains standars of donor selection, blood collection
and proper maintenance of collected blood components.
RufaidaMuhammad
 Delayed HTR
Definition Occurs at least after 24 hrs after
transfusion which mediated by IgG Ab
Causes 1. Mediated by IgG Ab:
-Patients exposed to RBC Ag
and has low Ab titer until
exposed again
-Rh, Kidd, Duffy, Kell
*Lab diagnosis:
DAT : -ve at first, then becomes +ve
Elutions: Performed to identify Ab
GVHD Post Transfusion Purpura (PPT)
Associated with transfusion that caused by Associated with first blood transfusion which
viable lymphocytes in the donor blood which is alloantibody directed against high
will multiply and attack HLA Ag that bound onincidence platelet antigen (P1A1) which
the recipient’s nucleated cells. usually occurs in multiparous women who do
not have the Ag.
Caused by: Donor lymphocytes transfused into Due to development of platelet
an imunocompromised (Low immune) alloantibodies
recipient
*Lab diagnosis:
1. Pancytopenia
2. Detection of donor DNA

Symptoms 1. Fever 1. Skin rash 1. Cerebral hemorrhage

2. Gradual ↓ Hemoglobinuria 2. Fever 2. Acute severe thrombocytopenia
3. Jaundice 3. Diarrhea
4. Hemoglobinuria 4. Liver dysfunction
5. Bone marrow failure

Prevention Must give Ag negative blood Give Irradiated RBC to destroy lymphocytes
RufaidaMuhammad