Reaction | Typical time course* | Clinical findings | Laboratory findings | Implicated products |
Acute hemolytic transfusion reaction | During transfusion or within 24 hours of transfusion completion | Fever, chills, hypotension, back pain, DIC | Hemoglobinemia, hemoglobinuria, positive direct antiglobulin (Coombs) test (may be negative if all cells have hemolyzed), findings of DIC (prolonged PT, prolonged aPTT, low fibrinogen, thrombocytopenia) | RBCs, plasma (much less common), rarely platelets Incompatible blood product (typically ABO incompatible due to clerical error) |
Anaphylactic transfusion reaction | During transfusion or within 4 hours of transfusion completion | Hypotension, angioedema, wheezing, respiratory distress | Hypoxemia, IgA deficiency, anti-IgA | RBCs, platelets, plasma products |
Transfusion-related acute lung injury (TRALI) | During transfusion or within 6 hours of transfusion completion | Respiratory distress, hypotension | Abnormal chest radiography, hypoxemia, transient leukopenia, anti-neutrophil or anti-HLA antibodies (if tested) | RBCs, platelets, plasma products |
Transfusion-associated circulatory overload (TACO) | During transfusion or within 12 hours of transfusion completion | Respiratory distress, rales | Abnormal chest radiography, hypoxemia, increased BNP or NT-proBNP | RBCs, platelets, plasma products, and other fluids |
Sepsis/bacterial infection | During transfusion or within 72 hours of transfusion completion | Fever, chills, hypotension, DIC | Bacteremia, leukocytosis, findings of DIC | Platelets most commonly implicated, but can be any product Product may show bacterial contamination |
Febrile non-hemolytic transfusion reaction | During transfusion or within 4 hours of transfusion completion | Fever | None | All blood products, but plasma is much rarer |
Allergic transfusion reaction | During transfusion or within 4 hours of transfusion completion | Hives, urticaria | None unless specific investigation is made | All blood products |
aPTT: activated partial thromboplastin time; BNP: brain natriuretic peptide; DIC: disseminated intravascular coagulation; HLA: human leukocyte antigens; Ig: immunoglobulin; NT-proBNP: N-terminal BNP; PT: prothrombin time; RBCs: red blood cells.
* Except for sepsis/bacterial infection, all typical time course criteria are from the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network Biovigilance Component. Septic transfusion reactions generally occur immediately after initiating the transfusion but may take time to develop depending on the size of the bacterial inoculum.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟