Transfusion Reactions

Transfusion Reactions



James Palis, MD



Basic Information



Definition


Transfusion reactions include urticaria, fevers, and hemolysis caused by antibodies in the recipient directed against components of the transfused product, including antigens on the red blood cells (RBCs) themselves, plasma proteins, or antigens on contaminating white blood cells or platelets.



Synonyms



Acute hemolytic reactions

Delayed hemolytic reactions

Febrile nonhemolytic reactions

Transfusion-related acute lung injury

Urticarial reactions


ICD-9-CM Code



999.8 Transfusion reaction


Epidemiology & Demographics



• Febrile nonhemolytic reactions occur as often as 1 in 100 units of RBCs transfused.

• Urticarial reactions occur as often as 1 in 1000 units of RBCs transfused.

• Delayed hemolytic reactions occur as often as 1 in 1000 units of RBCs transfused.

• Transfusion-related acute lung injury has an estimated frequency of 1 in 10,000 units of RBCs transfused, and it is more likely to occur in the setting of sepsis.

• Acute hemolytic reactions occur 1 in 250,000 to 1 in 1,000,000 units of RBCs transfused and are usually caused by administrative or clerical errors (i.e., misidentification of the blood sample tested or misidentification of the recipient receiving the transfusion).


Clinical Presentation



• Febrile nonhemolytic reactions can be associated with shortness of breath, pain in the chest, back or neck pain, fevers, tachypnea, and hypertension.

• Urticarial reactions can occur on a first transfusion and cause pruritus and hives.

• Delayed hemolytic transfusion reactions occur 3 to 14 days after a transfusion and are characterized by fever, jaundice, and hemoglobinuria.

• Transfusion-related acute lung injury causes dyspnea within 4 hours of a transfusion and is characterized by hypoxia and respiratory distress.
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Jun 19, 2016 | Posted by in PEDIATRICS | Comments Off on Transfusion Reactions

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