Transfusion reaction: Difference between revisions

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===Transfusion related acute lung injury (TRALI)===
===Transfusion related acute lung injury (TRALI)===
ICD9: {{ICD9|518.7}}
ICD9: {{ICD9|518.7}}
This is an acute reaction that may include hypoxemia, respiratory failure, hypotension, and fever.
Transfusion-related acute lung injury (pulmonary leukoagglutinin reaction) (TRALI) is an acute reaction that may include hypoxemia, respiratory failure, hypotension, and fever.


===Graft-versus-host disease===
===Graft-versus-host disease===
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* Circulatory overload
* Circulatory overload
* Hypotension associated with leukoreduced blood and [[angiotensin-converting enzyme]] may cause flushing and hypotension.
* Hypotension associated with leukoreduced blood and [[angiotensin-converting enzyme]] may cause flushing and hypotension.
* Transfusion-related acute lung injury (pulmonary leukoagglutinin reaction) (TRALI)


==References==
==References==

Revision as of 19:10, 6 November 2008

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A classification has been proposed by the American Association of Blood Banks (AABB).[1] In addition, the classification below is based on ICD9.

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. Antibodies present in the recipient's serum are directed against antigens in the donor product. Such a mismatch may result in a transfusion reaction in which, for example, donor blood is hemolyzed."[2]

Acute hemolytic transfusion reactions

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: 999.7

This reaction usually causes delayed hemolysis. This may be caused by Rh incompatibility.

Allergic reactions

Hypersensitivity reactions include:

  • Anaphylactic transfusion reactions may occur, especially in patients with IgA-deficiency.
  • Urticaria may occur due to the recipient's IgE reacting to antigens from the donor.

Transfusion related acute lung injury (TRALI)

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.

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

Transfusion associated sepsis may manifest 'fever > 40°C and/or cardiovascular collapse.'[1]

Other reactions

  • Air embolus may manifest 'sudden dyspnea, cyanosis, chest pain, cough, hypotension, cardiac arrhythmia.'[1]
  • Hypothermia
  • Circulatory overload
  • Hypotension associated with leukoreduced blood and angiotensin-converting enzyme may cause flushing and hypotension.

References

External links