From the Guidelines
If a transfusion reaction is suspected, immediately stop the transfusion and notify the blood bank and physician, as the risk of fatal hemolysis is estimated to be 1:1,250,000 or 8 per 10 million RBC units 1. When managing a transfusion reaction, it is crucial to maintain IV access with normal saline and monitor the patient closely. Common symptoms of transfusion reactions include:
- Fever
- Chills
- Back pain
- Hypotension
- Tachycardia
- Dyspnea
- Urticaria
- Anxiety The management of transfusion reactions depends on the type of reaction, with different treatments for febrile non-hemolytic reactions, allergic reactions, severe anaphylactic reactions, and acute hemolytic reactions. For example, febrile non-hemolytic reactions can be treated with acetaminophen 650mg, while allergic reactions can be managed with diphenhydramine 25-50mg IV 1. Prevention strategies are also essential in reducing the risk of transfusion reactions, including meticulous verification of patient identity and blood product compatibility, proper storage and handling of blood products, and slow initial transfusion rates with close patient monitoring for the first 15 minutes 1. Transfusion reactions can occur due to immunologic incompatibility between donor and recipient blood, presence of antibodies, or bacterial contamination of blood products, highlighting the importance of careful management and prevention strategies to minimize the risk of these adverse events 1.
From the Research
Transfusion Reaction Overview
- Transfusion reactions can occur despite blood transfusions being generally safe, carrying considerable risks 2
- Symptoms of transfusion reactions are often overlapping and nonspecific, making diagnosis and management critical 2
Diagnosis and Management
- When a reaction is suspected, it is critical to stop the transfusion immediately and report the reaction to the blood bank 2
- New evidence-based algorithms of transfusion, newer blood screening methods, and improved hemovigilance can help avoid unnecessary transfusions and decrease the incidence of serious transfusion reactions 2
- Immunohematological work-up must be rigorous to ensure transfusion management with utmost safety, especially in cases of alloimmune etiology 3
Related Conditions
- Hemolysis is a clinical entity that can be severe and is commonly of multifactorial etiology 3
- Transfusion support may be necessary in cases of severe anemia, but management can be more challenging if the etiology is partly alloimmune 3
Unrelated Studies
- There are studies unrelated to transfusion reactions, such as the function of calmodulin as an activator of Pur alpha binding to single-stranded purine-rich DNA elements 4