Hematology and Oncology Book

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Febrile Nonhemolytic Transfusion Reaction

Aka: Febrile Nonhemolytic Transfusion Reaction, FNHTR
  1. See Also
    1. Transfusion Complication
    2. Blood Transfusion
    3. Platelet Transfusion
    4. Cryoprecipitate
    5. Plasma Transfusion
    6. Transfusion Hemolysis
    7. Transfusion-Related Acute Lung Injury (TRALI)
  2. Pathophysiology
    1. White Blood Cells in Blood Product stimulate transfusion recipient Antibody binding reaction OR
    2. Proinflammatory cytokines contained in Blood Product
  3. Risk Factors
    1. Increased risk
      1. Repeat transfusions
      2. Pregnancy
      3. Platelet Transfusions
        1. Replaced pRBC transfusion as most common cause (due to Leukocyte reduced pRBC transfusion)
    2. Decreased risk
      1. Leukocyte reduced pRBC transfusion
        1. Filtering out Leukocytes from pRBCs prior to storage has resulted in decreased Incidence of FNHTR
  4. Signs
    1. Fever or Temperature increase of 1.8 F (1 C) within 4 hours of transfusion
    2. Chills
    3. Rigors
    4. Hypertension
    5. Tachycardia
    6. Tachypnea
  5. Precautions
    1. FNHTR is a diagnosis of exclusion
    2. Exclude more serious causes in differential diagnosis
  6. Differential Diagnosis
    1. Other causes of fever (e.g. Sepsis)
    2. Transfusion Hemolysis
  7. Management
    1. Symptomatic
    2. Antipyretics
      1. Prophylactic use does NOT prevent reaction
      2. However, consider prophylaxis when prior FNHTR reaction, as it may allow for transfusion completion
  8. Prevention
    1. Leukocyte reduction (leukoreduction) of cellular Blood Products (e.g. Packed Red Blood Cells)
    2. Washing and volume reduction of Platelet Transfusion
  9. References
    1. Raval (2020) Am Fam Physician 102(1):30-8 [PubMed]
    2. Sharma (2011) Am Fam Physician 83(6): 719-24 [PubMed]

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
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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