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Transfusion Complication

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Transfusion Complication, Transfusion Reaction, Immune Transfusion Reaction

  • Complications
  • Acute (within minutes to 24 hours)
  1. See Transfusion-Related Acute Lung Injury (TRALI)
  2. See Transfusion Associated Circulatory Overload (TACO)
  3. See Febrile Nonhemolytic Transfusion Reaction (FNHTR)
  4. See Allergic Transfusion Reaction
  5. Immune reaction (observe patient closely for the first 15 minutes of transfusion)
    1. Transfusion Hemolysis
    2. Allergic Transfusion Reaction
      1. Reaction to Antigens in donor's blood, not the blood type itself
    3. Anaphylaxis to Transfusion
      1. Associated with IgA deficient patients exposed to IgA in donor blood
    4. Urticaria
  6. Complication of Massive Transfusion
    1. Hyperkalemia
    2. Ammonia toxicity
    3. Citrate toxicity
    4. Dilutional Coagulopathy
    5. Thrombocytopenia
  7. Secondary Sepsis from Bacterial contamination of Blood Product
    1. Incidence: 1 per 100,000 transfusions overall (up to 1 in 3000 for Platelet Transfusion)
    2. Most common organisms are normal skin flora (Staphylococcus and Streptococcus)
    3. Onset within first 24 hours of transfusion
    4. Initiate early aggressive management on recognition of Sepsis
      1. Broad spectrum antibiotics including Gram Positive, Gram Negative and pseudomonas coverage
  8. Intravenous Access Complication
    1. Air embolism
    2. Thrombophlebitis
  • Complications
  • Delayed
  1. See Transfusion Associated Graft Versus Host Disease (TAGVHD)
  2. Delayed Transfusion Hemolysis (Extravascular Hemolysis due to minor incompatibility)
  3. Iron Overload (Hemochromatosis)
  4. Post-transfusion Purpura
  • 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