Acute transfusion reaction

Acute

1. Intravascular Hemolytic TR
   1. ABO incompatability --> serious
   2. Sx: fever/ch/joint or back pain/shock
   3. Tx: stop, fluids+lasix, re-check blood
2. Febrile TR
   1. anitbodies --> mild
   2. Sx: fever/ch/malaise
   3. Tx: R/O above
3. Allergic
   1. Tx as allergic Rx --> range
4. Transfusion-Related Acute Lung Injury (TRALI)
   1. Sx: acute ARDS-like injury --> severe
   2. Tx: stop trans, Tx as ARDS
5. Sepsis (Bacterial Contamination)
6. Fluid Overload

Delayed

1. Extravascular Hemolytic TR
   1. days-weeks after --> mild
   2. Sx: fever/anemia/jaundice
   3. Tx: none
2. Graft-vs-Host
   1. in leukemia/lymphoma pt if given trans after chemo (use leuk-poor components)
   2. Sx: fever/rash/n/v/inc LFTs/pancytopenia --> severe
   3. Tx: no effective Tx --> death
3. Hemosiderosis

Source

2/18/06 DONALDSON (adapted from Rosen)