Quick Review Cards for Medical Laboratory Science

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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