Pathology Outlines - Transfusion reaction

Transfusion medicine
General
Transfusion reaction

Topic Completed: 1 September 2011

Revised: 15 February 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

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Table of Contents

Definition / general | During the transfusion | After the transfusion | Mortality due to transfusion reactions

Cite this page: Pham, H.P. Transfusion reaction - general. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/transfusionmedtransfusionreactgen.html. Accessed October 16th, 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]