Transfusion reactions (week 3 hematology)

febrile non hemolytic reaction

from cytokines in donor blood or host ABxdonor MHC antigens, usually resolves within 30 mins, may use tylenol, prevenable with leukocyte filters or irradiation

febrile non hemolytic reaction s/s

fever, chills, headache, malaise, flushing

hemolytic reaction

from ABO incompatability with host ABxdonor antigen, stop transfusion & give fluids; most severe reaction

hemolytic reaction s/s

fever, chills, pain at site, dark urine, nausea, shock

allergic reaction

from plasma proteins, prevent with pretx, antihistamines; continue transfusion

allergic reaction s/s

urticaria, pruritus

anaphylactic reaction

host ABxIgA AB in plasma, stop immediately, epinepherine, prevent w washed or IgA deficient products

anaphylactic reaction s/s

urticaria, angioedema, wheezing, laryngeal edema, abd pain, hypotension, shock

TRALI

transfusion related acute lung injury

TRALI reaction

donor AB activates neutrophil antigens and cause endothelial damage, stop immediately, provide airway support; most common cause of transfusion r/t death

TRALI s/s

dyspnea, hypoxemia, bilateral chest infiltrates

TACO

transfusion associated circulatory overload

TACO reaction

rapid volume expansion, support, diuretics, prevent w slow transfusions & diuretics

TACO s/s

dyspnea, HTN, pulmonary & peripheral edema, crackles in lungs