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Transfusion medicine
General
Transfusion reaction
Copyright: 2002-2019, PathologyOutlines.com, Inc.
PubMed Search: Transfusion reaction [title] "loattrfree full text"[sb]
General
Transfusion reaction
Author: Huy Phu Pham, M.D., M.P.H.
Topic Completed: 1 September 2011
Revised: 15 February 2019
Copyright: 2002-2019, PathologyOutlines.com, Inc.
PubMed Search: Transfusion reaction [title] "loattrfree full text"[sb]
Table of Contents
Definition / general | During the transfusion | After the transfusion | Mortality due to transfusion reactionsCite this page: Pham, H.P. Transfusion reaction - general. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/transfusionmedtransfusionreactgen.html. Accessed June 19th, 2019.
Definition / general
- Can be identified during or after the transfusion
- The goal is to rule out hemolytic transfusion reaction
During the transfusion
- Stop the transfusion
- Keep IV line open with saline
- Contact the physician on call for immediate assessment of the patient
- Monitor vital signs closely
- Report to blood bank / transfusion service
- Should provide the on call transfusion medicine physician with:
- Patient’s name, medical record number
- Blood type and history of antibody
- Transfusion history, including pregnancy, history of transfusions and transfusion in the past 3 months
- Type of product transfused
- Amount of product transfused
- Patient’s symptoms and the temporal relationship to transfusion
- Pre and posttransfusion vital signs
- Premedication and treatment for the transfusion reaction (if any)
- Blood bank should also perform clerical check, visual check for hemoglobinemia (comparing to pretransfusion sample), and DAT (direct antiglobulin test, also comparing to the pretransfusion sample)
- Check patient and unit information for clerical errors
- Send hemolysis labs, including posttransfusion CBC, total and direct bilirubin, LDH, haptoglobin, and UA with microscopic for hemoglobinuria
- Document the transfusion reaction in the medical chart
- Contact transfusion medicine physician on call regarding further release of blood products
- Continue to observe the patient carefully
After the transfusion
- Contact the blood bank / transfusion medicine service to report possible delayed transfusion reaction
- Determine the cause of the reaction
- Document the transfusion reaction in the medical chart
- Continue to observe the patient carefully
- Algorithm for working up a transfusion reaction Novascotia.ca: Algorithm for Transfusion Reactions [Accessed 20 October 2017], CMAJ: What Every Physician Should Know about Transfusion Reactions [Accessed 20 October 2017]
- Incidence of transfusion reactions Ontario Regional Blood Coordinating Network: Bloody Easy: Blood Administration - A Handbook for Health Professionals [Accessed 20 October 2017]
Mortality due to transfusion reactions
- Need to report to the FDA as soon as possible U.S. Food & Drug Administration: Transfusion/Donation Fatalities [Accessed 20 October 2017]
- Incidence of transfusion related mortality U.S. Food & Drug Administration: Fatalities Reported to FDA Following Blood Collection and Transfusion: Annual Summary for Fiscal Year 2009 [Accessed 20 October 2017]
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