II. Complications: Acute (within minutes to 24 hours)

  1. Immune reaction (observe patient closely for the first 15 minutes of transfusion)
    1. Transfusion Hemolysis
    2. Allergic Reaction
      1. Reaction to antigens in donor's blood, not the blood type itself
    3. Anaphylaxis
      1. Associated with IgA deficient patients exposed to IgA in donor blood
    4. Urticaria
  2. Febrile Nonhemolytic Transfusion Reaction (FNHTR)
    1. Fever within 24 hours of transfusion sometimes associated with chills or rigors
    2. Diagnosis of exclusion - first rule out other causes of fever (e.g. Sepsis)
    3. More common with repeat transfusions or in pregnancy
    4. Less common now since most centers filter pRBCs of Leukocytes prior to storage
    5. Now Platelet Transfusions are most commonly associated with FNHTR
  3. Circulatory Overload
    1. Infants
    2. Renal Insufficiency
    3. Cardiac insufficiency (CHF)
  4. Complication of Massive Transfusion
    1. Hyperkalemia
    2. Ammonia toxicity
    3. Citrate toxicity
    4. Dilutional Coagulopathy
    5. Thrombocytopenia
  5. Intravenous Access Complication
    1. Secondary Sepsis from Bacterial contamination of blood product
    2. Air embolism
    3. Thrombophlebitis
  6. Transfusion-Related acute lung injury (TRALI)
    1. Acute pulmonary edema within 6 hours of transfusion (non-cardiac)
    2. Leading cause of transfusion associated mortality
    3. Associated with ANCA and HLA Antibody mediated lung injury
    4. May be associated with plasma donated by multiparous women

III. Complications: Delayed

  1. Delayed hemolytic reaction
  2. Iron Overload (Hemochromatosis)
  3. Post-transfusion Purpura
  4. Transfusion-associated graft-versus-host disease
    1. Onset 6 weeks after transfusion
    2. Presents with rash, fever, Diarrhea, liver abnormalities, and Pancytopenia
    3. Fatal in 90% of cases
    4. Donor Lymphocyte reaction against host tissue
    5. Risk factors include immunosuppresion

IV. Causes: Infection

  1. Hepatitis B Virus Infection (1 in 350,000)
  2. Hepatitis C Virus Infection (1 in 1.8 Million)
  3. Human T-Lymphotrophic Virus 1 or 2 (1 in 2 Million)
  4. Human Immunodeficiency Virus (1 in 2.3 Million)
  5. Malaria (rare)
  6. Babesiosis (rare)
  7. Pandemic Influenza (rare)
  8. Human Herpes Virus 8 (rare)
  9. West Nile Virus (rare)
  10. Creutzfeldt-Jakob Disease (rare)
  11. Syphilis
  12. Cytomegalovirus (CMV)
  13. Toxoplasmosis
  14. Brucellosis

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Ontology: Transfusion Reaction (C0274435)

Definition (MSH) Complications of BLOOD TRANSFUSION.
Definition (NOC) Severity of complications with blood transfusion reaction
Concepts Pathologic Function (T046)
MSH D001787 , D065227
ICD9 999.80
ICD10 T80.92
SnomedCT 270554002, 157797009, 213330007, 82545002
LNC LP18652-5, MTHU005052, LA7476-0
Italian Reazione da trasfusione
Japanese 輸血反応, ユケツハンノウ
English Blood Transfusion Reaction, complication of blood transfusion (diagnosis), complication of blood transfusion, blood transfusion reaction, blood transfusion reaction (diagnosis), blood transfusion complications, Transfusion reaction, unspecified, Adverse effect;transfusion, blood transfusion reactions, reactions transfusion, blood complications transfusion, blood complications transfusions, blood reaction transfusion, blood transfusion complication, transfusion reaction, blood complication transfusion, transfusion reactions, blood reactions transfusion, Transfusion reaction NOS, Unspecified transfusion reaction, Transfusion reaction NOS (disorder), Transfusion Reactions, Transfusion Reaction, Transfusion reaction, Complication of blood transfusion, Blood transfusion reaction (disorder), Blood transfusion reaction, complications; transfusion, reaction, transfusion; complications, reaction, Blood transfusion reaction, NOS, Complication of blood transfusion, NOS, Transfusion reaction, NOS
Czech Transfuzní reakce
Hungarian Transzfúziós reakció
Spanish reacción transfusional, SAI (trastorno), reacción transfusional, SAI, complicación de la transfusión de sangre, reacción a la transfusión de sangre (trastorno), reacción a la transfusión de sangre, reacción a una transfusión, Reacción transfusional
Norwegian Transfusjonsreaksjon
Dutch complicaties; transfusie, reactie, transfusie; complicaties, reactie, transfusiereactie
Portuguese Reacção transfusional
French Réaction post-transfusionnelle
German Transfusionsreaktion

Ontology: Transfusion related acute lung injury (C0948343)

Concepts Disease or Syndrome (T047)
SnomedCT 389078002
Italian Traumatismo polmonare acuto correlato a trasfusione, TRALI
Japanese 輸血関連急性肺障害, ユケツカンレンキュウセイハイショウガイ, TRALI, TRALI
Spanish lesión aguda de pulmón relacionada con transfusión, LPART, Lesión pulmonar aguda relacionada con transfusión, lesión aguda de pulmón relacionada con transfusión (trastorno), lesión traumática aguda de pulmón relacionada con transfusión (trastorno), lesión traumática aguda de pulmón relacionada con transfusión
French TRALI (Syndrome de détresse respiratoire aiguë post-transfusionnel), Lésion aiguë du poumon liée à la transfusion
Dutch TRALI, transfusiegerelateerd acuut longletsel
Portuguese LGPLT (Lesão grave do pulmão ligada à transfusão), Lesão traumática pulmonar aguda relacionada com transfusão
German TRALI-Syndrom, transfusionsbedingte akute Lungenverletzung
Czech Akutní plicní poranění v souvislosti s transfúzí, TRALI
Hungarian Transzfúzióval összefüggő akut tüdőkárosodás, TRALI
English Transfusion-related acute lung injury, TRALI, Transfusion related acute lung injury (disorder), Transfusion related acute lung injury

Ontology: Transfusion related complication (C1112143)

Concepts Pathologic Function (T046)
Italian Complicazioni correlate a trasfusione, Complicazione correlata a trasfusione
Czech Komplikace spojené s podáním krevních derivátů, Komplikace související s transfuzí
English Transfusion related complication, Transfusion related complications, complications; transfusion, transfusion; complications
Spanish Complicación relacionada con transfusión, Complicaciones de la transfusión sanguínea
Portuguese Complicação relacionada com transfusão, Complicações associadas a transfusões
German Komplikation in Verbindung mit Transfusion, Transfusionsbedingte Komplikationen
French Complication liée à la perfusion, Complications de la transfusion
Dutch transfusiegerelateerde complicatie, complicaties; transfusie, transfusie; complicaties, transfusiegerelateerde complicaties
Hungarian Transzfúzióval kapcsolatos komplikációk, Transzfúzióval összefüggő komplikáció
Japanese ユケツカンレンガッペイショウ, 輸血関連合併症

Ontology: Febrile nonhaemolytic transfusion reaction (C1739123)

Concepts Pathologic Function (T046)
ICD9 780.66
ICD10 R50.84
English Febrile nonhaemolytic transfusion reaction, Febrile nonhemolytic transfusion reaction, Feb nonhemo transf react, FNHTR
Dutch febriele niet-hemolytische transfusiereactie
French Réaction non hémolytique fébrile à la transfusion
German febrile nicht-haemolytische Transfusionsreaktion
Italian Reazione febbrile non emolitica da trasfusione
Portuguese Reacção transfusional não-hemolítica febril
Spanish Reacción febril post-transfusional no hemolítica
Japanese 発熱性非溶血性輸血反応, ハツネツセイヒヨウケツセイユケツハンノウ
Czech Febrilní nehemolytická reakce na transfúzi
Hungarian Lázas nem haemolyticus transzfúziós reakció