adversetransfusionreaction
Adverse Transfusion Reaction
ADVERSE REACTIONS TO BLOOD TRANSFUSION:
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 .
Transfusion reactions may be divided as follows :
ACUTE (<24 hrs):
Delayed adverse reactions to Transfusion (<24 hrs) :
Nonimmunologic :
Iron overload
Transfusion transmitted diseases
multiple transfusion.
Hepatitis, HIV cytomegalovirus etc.
FEBRILE NON HEMOLYTIC TRANSFUSION REACTION: (FNHTR).
ALLERGIC URTICARIAL REACTION:
ACUTE IMMUNE HEMOLYTIC TRANSFUSION REACTION:
(AIHTR):
"Any febrile reaction is treated as AIHTR unless proven otherwise."
TREATMENT AND WORK UP OF AIHTR:
NON IMMUNE HEMOLYSIS: BACTERIAL CONTAMINATION:
TREATMENT AND WORKUP:
PREVENTION:
-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.
ANAPHYLACTIC REACTION:
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TRALI (TRANSFUSION RELATED ACUTE LUNG INJURY):
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TRANSFUSION ASSOCIATED GRAFT VERSUS HOST DISEASE:
ANAPHYLACTOID REACTION TO ACE INHIBITION:
Reaction :
flushing and hypotension in patients on ACE inhibitors
Mechanism :
Prekallikrein present in blood and blood product is converted to vasoactive bradykinin whose metabolism is inhibited by ACE inhibitors resulting in hypotension.
Procedures associated :-
Therapeutic plasma exchange with albumin replacement
Contact of plasma with dialysis membrane
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DELAYED HEMOLYTIC TRANSFUSION REACTION:
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POST TRANSFUSION PURPURA::