Complications of blood transfusion Department of General Surgery, Viswabharathi Medical College, Kurnool

1. Complications of Blood transfusion
D. VIGHNESH
4th Year MBBS, VMC KNL

2. Introduction
Blood transfusion is associated with several potential complications. These
include febrile and urticarial reactions, acute hemolytic transfusion
reactions, delayed hemolytic transfusion reactions, metabolic disturbances,
and the transmission of disease.

3. Complications from blood transfusion are further
categorised as that from single transfusion, or from a
massive transfusion reaction.

4. Complications from single blood transfusion
● Incompatible haemolytic transfusion reaction
● Febrile Transfusion reaction
● Allergic reaction
● Infections
Bacterial (most commonly due to bad storage practices)
Hepatitis
HIV
Malaria
● Air embolism
● Thrombophlebitis
● TRALI (most commonly from fresh frozen plasma

5. PATHOPHYSIOLOGY OF SOME COMPLICATIONS

6. Complications from massive blood transfusion
● Coagulopathy
● Hypocalcemia: Ca2+
● Hypokalemia: K+
● Hyperkalemia: K+
● Iron Overload: Fe2+
● Hypothermia

7. Management

8. Coagulopathy following or during massive transfusion should be predicted and
managed aggressively. The protocols are:
● Fresh Frozen Plasma is to be administered if PT or PTT more than 1.5 times
normal.
● Cryoprecipitate is to be administered if Fibrinogen levels are less than 0.8 g/L
● Platelets to be administered if platelet count is less than 50 x 10^9/mL
In case of non-surgical scenarios, the treatment should be based on the clinical
evidence.
Pharmacological therapy includes active administration of antifibrinolytics like
Tranexamic Acid and aprotinin. Recomb. Factor VII a can also be considered.

9. SUMMARY
Massive transfusion is an important life-saving intervention for patients with massive acute
blood loss. Although the etiology of bleeding is different in all of the cases, the same
principles of massive transfusion apply. Massive transfusion can, however, have serious
complications and should be reserved for patients with hemodynamic instability as a bridge
to definitive therapy
In general, when massive blood transfusions are done especially in the setting of trauma,
the potential for complications is high. Some studies indicate that no more than 20-30 units
of blood should be given to avoid complications. Overall, most studies reveal that such
transfusions do not lead to patient survival but in fact, are associated with many adverse
events.

10. THANK YOU
References
1. Bailey and Love’s Short Practice of Surgery 26th
Ed.
2. https://www.ncbi.nlm.nih.gov/books/NBK499929/
#article-39308.s10
3. https://www.researchgate.net/publication/281311
044_Transfusion-
Related_Acute_Lung_Injured_TRALI_current_co
ncepts/figures?lo=1