This presentation will throw light on transfusion reactions that are commonly observed in blood bank. These transfusion reactions are minor or allergic but sometime results in sever reactions and in severe cases may eventually leads to death of patient.

1. THE UNIVERSITY OF HARIPUR
DEPARTMENT OF MEDICAL LAB TECHNOLOGY
PRESENTATION TOPIC:
BLOOD TRASFUSION REACTIONS
PRESENTED BY: KINZA HAROON. (F17-0664)
PRESENTED TO: MA’AM NAILA QMAR

2. CONTENT:
• INTRODUCTION.
• TRANSFUSION REACTIONS.
• CAUSES OF TRANSFUSION REACTIONS.
• CLASSIFICATIONS OF TRANSFUSION
REACTIONS.
• COMPLICATIONS ASSOCIATED.
• SIGN AND SYMPTOMS.
• LABORATORY DIAGNOSIS.
• MANAGEMENT.
• PRECAUTIONS.
• SUMMARY.
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3. 1. INTRODUCTION:
• Blood transfusions are integral part of medicine, and is the process by which blood and its
components are added into others circulation intravenously.
• Blood transfusion basically replaces blood in person that has been lost due to any surgery, injury or
body may lost property of making blood actively and properly.
• Blood transfusion sometimes results in serious hemolytic transfusion reaction, that arises when
transfused red blood cells are destroyed by person immune system.
• Blood transfusion reactions are sever complications sometime result in death of patient, if are not
managed timely, they are typically common in patients with sever blood loss or diseased.
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4. 2. CAUSES OF TRANSFUSION REACTION:
Most common causes of transfusion reactions are;
• Misidentification of patient.
• Improper sample identification.
• Wrong or contaminated blood transfusion.
• Administration error.
• Technical faults, like errors in blood grouping and cross-match, or incorrect result interpretation.
• Expired blood transfusion.
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5. 3. CLASSIFICATION OF TRASFUSION REACTIONS:
Transfusion
reactions
Immune
mediated
hemolytic
immediate
delayed
Non-
hemolytic
immediate
delayed
Non-
immune
mediated
immediate
Delayed
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6. 4. TRANSFUSION REACTIONS:
• Infectious;
 Viral
 Bacterial.
• Non-Infectious;
Reactions to RBC’s antigen;
 Acute hemolytic transfusion reactions,
 Delayed hemolytic transfusion reactions.
Reactions to donor proteins;
 Minor allergic reactions,
 Anaphylactic reactions.
White cell related transfusion reactions;
 Febrile reactions,
 Transfusion related acute lung injury.
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7. 5. COMPICATIONS OF TRANSFUSION REACTION:
Complications that arises because of transfusion reactions are;
• Febrile transfusion reactions.
• Hemolytic transfusion reactions.
• Allergic reactions.
• Transfusion related acute lung injury.
• Transfusion associated circulatory overload.
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8. 5.1. FEBRILE TRANSFUSION REACTIONS:
• Febrile transfusion reactions results in release of cytokines release by donor leukocytes.
• Febrile non-hemolytic transfusion reactions are generally results of an incompatibility between
leukocytes in erythrocyte product and antibody in recipient plasma.
• Most commonly experienced in 1 of 10 pooled platelets transfusion, and 1 in 3000 units of RBC’s.
• Usually starts with in 30 min, patients experience;
• Fever, chills, cold, shaking,
• Diastolic BP rises, headache, nausea, vomiting.
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9. 5.2. HEMOLYTIC TRANSFUSION REACTIONS:
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• Hemolytic transfusion reactions occurs when mismatch blood is transfused to patient mainly du to
presence of anti-A and anti-B antibodies.
• Incidence of hemolytic transfusion reactions are 1 per 6000 or 7000 blood units and mortality
ranges from 20%-60%.
• Infusion of ABO incompatible blood mostly results due to errors in labelling, testing or
identification, transfusion is stopped as soon as possible and patients are shifted to intense care
unit.

10. 5.3. ALLERGIC REACTIONS:
• Allergic reactions are reported to ~1-3 % of all blood transfusions, severe allergic reaction
(anaphylactic shock) 1in 200,000 patients receiving transfusion of blood and blood components.
• Symptomatic treatment most commonly antihistamines are given to patient, no need to stop blood
transfusion.
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11. 5.4. TRANSFUSION RELATED LUNG INJURY:
• Acute lung injury is due to reaction between donor antibodies and recipient antigens, symptoms
generally develop within 6 hours of transfusion.
• The recipients immune system respond and results in release of mediators that eventually leads to
pulmonary edema.
• Incident rate includes 1 in 5000 units of packed red blood cells, 1 in 2000 plasma containing
components and 1 in 400 units of whole blood derived platelets concentrates.
• Clinical characteristic include, acute dyspnea, hypoxemia, fever, hypotension, tachycardia,
thrombocytopenia and leukopenia.
• Immediate treatment include, stop transfusion, blood bag screening for antileukocytic antibodies, anti-
HLA, or HNA antibodies, rest of supportive treatment involve oxygenation.
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12. 5.5. TRANSFUSION ASSOCIATED CIRCULATORY OVERLOAD:
• Transfusion associated circulatory overload is common transfusion reaction in which pulmonary
edema develops primarily due to volume access or circulatory overload.
• Most commonly presented in patients who receive massive transfusion in short time span, or
patients suffering with cardiovascular diseases or renal disease.
• Most likely to occur within 12 hours after blood transfusion, and patient may experience
tachycardia, hypertension and pulmonary edema.
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13. 6. SIGN and SYMPTOMS:
Most of transfusion reactions could be identified
within 15 min of transfusion, most common
transfusion reaction that occurs are;
• Fever, chills, chest pain,
• Nausea, dyspnea, vomiting,
• Hemoglobinuria, acute renal failure,
• Shock and disseminated intravascular
coagulation.
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14. 7. LABORATORY DIAGNOSIS:
Common laboratory features are;
• Hemoglobinemia,
• Hemoglobinuria,
• Decreased serum haptoglobin,
• Decreased hemoglobin level,
• Increased LDH and AST levels,
• Microbiological cultural.
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15. 8. MANAGEMENT OF TRANSFUSION REACTIONS:
• Stop blood transfusion immediately.
• Keep eye on vital sign of patient.
• Maintain intravenous access (do not again puncture existing line try to locate new vein for
transfusion) .
• Check label on blood bag before transfusion.
• Notify medical officer and transfusion service provider.
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16. 9. PRECAUTIONS:
Eliminate the risk of errors by identifying problem;
• Correct phlebotomy, by following all quality control protocols.
• Identify factors chain members, from collection to donation.
• Educational trainings, seminars and workshops organization on such topics for technicians.
• Research.
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17. 10. SUMMARY:
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