Transfusion Reactions

OBJECTIVES:

  • Differentiate between different types of transfusion reactions
  • Initial management of a patient with suspected transfusion reaction

TRANSFUSION REACTIONS (~ 20 min)

Board Set-Up:

Final Board


EVALUATION AND MANAGEMENT OF SUSPECTED TRANFUSION REACTIONS (~ 15 min)

Transfusion reactions can be separated into 4 broad symptomologies – fever, allergic symptoms, respiratory symptoms and other.

Because transfusion reactions can be severely life threatening, the initial management of all patients with a suspected transfusion reaction is to STOP the transfusion! Maintaining IV access is important because supportive therapies and volume resusictation is needed for several transfusion reactions.

The two most common transfusion reactions, allergic/urticarial and febrile non-hemolytic reactions, are non-life threatening and the transfusion can be restarted after a period of observation and clinical stability. However, the initial signs/symptoms of these two reactions can be difficult to differentiate from other more serious reactions. The blood bank/ transfusion services should be informed in most transfusion reactions to aid in the evaluation. They often have protocols in place that guide testing for hemolytic or immunologic reactions.



TAKE HOME POINTS: 


CLINICAL CASES:

In progress. Please contact us if you have a case to submit!


REFERENCES:

  1. Delaney, M, et al. 2016. “Transfusion reactions: prevention, diagnosis, and treatment.” Lancet. 388: 2825-2836.
  2. Silvergleid, A. Immunologic Transfusion Reactions. Tinauer, JS, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com (Accessed on October 02, 2017.)