Febrile non-haemolytic transfusion reactions

  • Due to cytokines or other biologically active molecules that accumlate during storage of blood components
  • 10-30% after platelet transfusion, 1-2% after RBC transfusion
  • Rise in temperature (\pm) rigors (\pm) tachycardia self-resolves

Transfusion Associated circulatory overload

  • Raised BP (and associated symptoms) and JVP
  • RF: patients with compromised left ventricular function or fluid balance problems

Acute haemolytic reaction

Antibodies against antigens of transfused RBCs type II hypersensitivity - most often ABO incompatibility. Fatal 20-30%

  • Free haemoglobin can damage kidneys AKI, trigger coagulation cascade (\rightarrow) DIC

Delayed haemolytic reaction - Coomb’s Test

New IgG formed against RBC antigens other than ABO.

  • 3-14 days following transfusion
  • Fatigue Jaundice, (\downarrow) Hb, (\uparrow) LDH, (\uparrow) indirect bilirubin