Acute Immunologic Transfusion Reactions* Immunohematology Review 473
TYPE CLINICAL SIGNS CAUSE LABORATORY FINDINGS OTHER
Hemolytic,
intravascular
Febrile
Allergic
Anaphylactic
Most serious rxn. May be fatal. Usually
due to tf of ABO-incompatible blood.
Common. Most often in multiply
transfused pts or women with multiple
pregnancies. Future tfs should be with
leukoreduced components. Antipyretics
(aspirin, acetaminophen) can be used
to premedicate.
Common. Treat with antihistamines.
Tf rxn investigation not required.
Rare, but dangerous. Treated with
epinephrine. Transfuse with washed
products.
Immediate destruction
of donor RBCs by
recipient ab
Anti-leukocyte abs
or cytokines
Foreign plasma
proteins
Anti-IgA in IgA-
deficient recipient
Fever; chills; shock;
renal failure; DIC;
pain in chest, back,
or flank
Temp ↑ ≥ 1 ºC or
2 ºF during or shortly
after tf, with no
other explanation
Hives (urticaria),
wheezing
Pulmonary edema,
bronchospasms
In post-tf specimens: HGB
in urine & serum; mixed-
field DAT (unless donor
cells are all destroyed); ↓
haptoglobin, HGB, & HCT
None
None
None
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