Transfusion Reaction abbreviated

Acute Hemolytic Transfusion Reaction (AHTR)

• Onset During or ≤24 hrs

• Cause ABO incompatibility, intravascular hemolysis

• Dx criteria Positive DAT with hemolysis labs, rapid onset

• Tx Stop transfusion, fluids, treat DIC, maintain urine output

Delayed Hemolytic Transfusion Reaction (DHTR)

• Onset 3–14 days

• Cause Anamnestic alloantibody (Kidd, Duffy, Kell)

• Dx criteria New alloantibody, positive DAT, delayed anemia

• Tx Supportive, antigen-negative units in future

Febrile Nonhemolytic Transfusion Reaction (FNHTR)

• Onset ≤4 hrs

• Cause Cytokines or anti-WBC Ab

• Dx criteria Fever ≥1°C, no hemolysis, negative cultures

• Tx Antipyretics, leukoreduced products

Mild Allergic Reaction

• Onset During/soon after

• Cause IgE to donor plasma proteins

• Dx criteria Urticaria/pruritus without fever or hypotension

• Tx Antihistamines, resume if resolved

Anaphylactic Reaction

• Onset Seconds–minutes

• Cause IgA deficiency with anti-IgA

• Dx criteria Hypotension, airway compromise, no fever

• Tx Epinephrine, airway support

TRALI

• Onset ≤6 hrs

• Cause Donor anti-HLA/HNA Ab → lung injury

• Dx criteria Acute hypoxemia, CXR infiltrates, normal BNP

• Tx O₂/ventilation, avoid diuretics

TACO

• Onset ≤6 hrs

• Cause Volume overload

• Dx criteria Dyspnea, hypertension, ↑ BNP, overload signs

• Tx Stop transfusion, diuretics, O₂

Bacterial Contamination / Septic Reaction

• Onset Minutes–hours

• Cause Contaminated product (platelets > RBCs)

• Dx criteria Fever, hypotension, positive cultures

• Tx Broad-spectrum antibiotics, supportive care

TA-GVHD

• Onset 3–30 days

• Cause Donor T cells attack recipient

• Dx criteria Rash, diarrhea, hepatitis, pancytopenia

• Tx Supportive, often fatal

Post-Transfusion Purpura (PTP)

• Onset 5–12 days

• Cause Anti-HPA Ab destroy platelets

• Dx criteria Severe thrombocytopenia post-transfusion

• Tx IVIG, plasmapheresis

Hypotensive Transfusion Reaction

• Onset Minutes

• Cause Bradykinin accumulation (ACEi + leukoreduced)

• Dx criteria Isolated hypotension, no fever/rash

• Tx Supportive BP care