Adverse Transfusion Reaction
Any adverse reaction that occurs during the administration of blood and blood component must be considered as transfusion reaction unless proved otherwise.
Transfusion reactions occur in 7% to 10% of all recipient of blood or blood components.
Fortunately, majority of them are minor reactions.
10% of these reactions are hemolytic and 90% of these are nonhemolytic reactions.
Incidence of ABO mismatch blood being infused is 1 : 30,000 blood bag.
1 out of 10 ABO mismatch transfusion is fatal .
Iron overload
Transfusion transmitted diseases
multiple transfusion.
Hepatitis, HIV cytomegalovirus etc.
"Any febrile reaction is treated as AIHTR unless proven otherwise."
-STOP TRANSFUSION
-Inspect blood bag for sign of bacterial overgrowth, Cells or plasma, brownish or purple color, Clots, opaque or muddy Plasma, Peculiar odor, Hemolysis.
-Do Gram stain for organism.
-Send cultures from blood bag at 4 degree Celsius , 20-24 degree Celsius, 35-37 degree Celsius.
-Antibiotics
-Treatment similar to AIHTR
-Attention to storage conditions
-Proper sterilization of phlebotomy site
-Sterile connecting device while component preparation
-Inspection of blood prior to issue
-Education of transfusionist regarding proper administration of blood
-Open system to be infused with in 24 hrs and preferably before 6 hrs of preparation.
flushing and hypotension in patients on ACE inhibitors
Prekallikrein present in blood and blood product is converted to vasoactive bradykinin whose metabolism is inhibited by ACE inhibitors resulting in hypotension.
Therapeutic plasma exchange with albumin replacement
Contact of plasma with dialysis membrane