blood

1. Dr. sandeep singh
NSCGMC Khandwa
Transfusion Transmitted Reaction

2.  Transfusion reaction are generally classified into 2 types-
1.Immune- Immunological reactions may be against RBC,
Leucocytes, platelets and immunoglobins.
2.Non-immune- non-immune transfusion reaction include circulatory
overload, massive transfusion or transmission of an infectious
agents.

3. Immunological transfusion reaction
 Immediate TR (min or hours)
1. Hemolytic
2. Febrile nonhemolytic
3. Allergic
4. TRALI
 Late TR (days, years)
1. Hemolytic
2. Allo-immunisation
3. Post transfusion purpura
4. GVHD
5. Immune modulation

4.  Acute hemolytic transfusion reaction-
 Pathophysiology- RBC mismatch between donor and recipient
 C/F- fever, chills/ rigors, back pain, hypotension, hemoglobinuria,
pain along IV line, bleeding diathesis

5.  Febrile nonhemolytic transfusion reaction-
 Pathophysiology- cytokines in blood unit.
 c/f- Rise in temperature, chills/ rigors. Discomfort, vomiting and
flushing

6.  Allergic-
 Pathophysiology- recipient’s IgE react with donor plasma protein
leading to release of mast cell mediators.
 c/f- pruritus, urticaria or flushing.

7.  Anaphylactic-
 Pathophysiology- antibodies to donor plasma protein including IgA ,
haptoglbins, complements, ethylene oxide.
 c/f- hypotension , urticaria, bronchospasm, stridor, local edema.

8.  Transfusion related lung injury-
 Pathophysiology- leucocytes antibodies in donor or recipient
 c/f hypoxemia, noncardiogenic pulmonary edema, respiratory
failure, hypotension, fever, cynosis.

9.  Delayed hemolytic transfusion reaction-
 c/f- fever, decreasing hematocrit, mild icterus with other features of
hemolysis.
 Alloimmunization-
 Pathophysiology- immune response to red cells, platelets,
leucocytes antigens refractoriness
 c/f- hemolytic disease of fetus and newborn, delayed serologic
reaction

10.  Translation associated immunomodulation-
 Allogenic leucocytes or their soluble products
 c/f increased chances of postoperative infections, cancer
recurrence, multiple organ dysfunction
 Transfusion associated graft versus host disease-
 c/f rashes, watery diarrhoea, fever, anorexia, vomiting abnormal
LFT , bone marrow failure

11.  Post transfusion purpura-
 Antibodies against platelet specific antigens
 c/f thrombocytopenia, purpura, bleeding

12. NON IMMUNE TRANSFUSION REACTIONS
 Transfusion related sepsis-
 Blood product contaminated with bacteria
 c/f fever, chills, hypotension within 90 min of transfusion
 Non immune hemolysis-
 Physical/ mechanical/ chemical destruction of blood
 Features of intravascular hemolysis of red cells, hemoglobinuria,
hemoglobinemia

13.  Transfusion associated circulatory overload
 c/f signs of CCF , shortness of breath, wheezing, hypotension
 Air embolism-
 Air infusion via IV line
 Sudden dyspnoea, acute cyanosis, shoulder or back pain, cough,
hypotension