Complications of Blood Transfusion
Occur due to
Collection site
Preparation
Storage
Cross matching
Collection from blood bank
Ward – Mislabelling, Fail to identify, Clerical
Hazards of Transfusion
Immune complications
Non-immune complications
Acute
Febrile non-haemolytic
transfusion reactions
Acute haemolytic
transfusion reactions –
Intravascular (IgM),
Extravascular (IgG)
Allergic reactions (urticarial)
Anaphylactic reactions
(anti-IgA)
TRALI
(transfusion-related acute
lung injury)
Bacterial – Acute sepsis/
Endotoxic shock
Hypothermia
Hypocalcaemia
↓ Ca2+ in infants
Air embolism (rare)
Delayed
(days → years)
Delayed haemolytic
transfusion reactions
Post-transfusion purpura
(PTP)
Transfusion-associated
graft-versus-host disease
(TA-GvHD)
Immune modulation
HIV
Hepatitis C
Hepatitis B
CMV
Others – parvovirus B19,
Hepatitis A, Malaria,
Chagas’ disease, Brucellosis,
Syphilis, vCJD
Immune Complications
Definition
Sensitization of recipient to donor blood cells, platelets, plasma proteins
Transfused cells/ serum may mount an immune response against recipient
(less commonly)
Classified
Haemolytic – Destruction of transfused blood cells by recipient’s antibodies
(Transfused antibodies ↓ commonly cause hemolysis of recipient’s blood cells)
(Acute/ Intravascular)(Delayed/ Extravascular)
Non-Haemolytic – Sensitization of Recipient to Donor White cells, Platelets,
Plasma proteins
(Reactions – Febrile, Urticarial, Anaphylactic, Pulmonary Edema (non-
cardiogenic), Graft vs. Host, Purpura, Immune Suppression)
Non-Immune Complications
Classified
Associated with Massive Blood Transfusion
Infectious complications
Viral Transmission
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Immune Complications
Immune Haemolytic Transfusion Reaction (Immune HTR)
Definition
Premature destruction of red cells in recipient of a transfusion caused by red cells
immune alloantibodies
Features depend on
Site of red cell destructi