要約

• Prompt recognition of an immune-mediated transfusion reaction is fundamental to improving patient outcome.
• Immune-mediated transfusion reactions can be classified as acute or delayed. Acute reactions occur within 24 hours of transfusion and include acute haemolytic, febrile non-haemolytic, allergic, and transfusion-related acute lung injury (TRALI). Delayed reactions occur days to weeks after the transfusion and include delayed haemolytic transfusion reactions, transfusion-associated graft-versus-host disease, and post-transfusion purpura.
• Prompt recognition of an immune-mediated transfusion reaction is fundamental to improving patient outcome. Although infrequent, non-immune transfusion reactions, including haemolysis, transfusion-associated sepsis, and circulatory overload, should be considered in the differential diagnosis.
• Acute haemolytic transfusion reactions are most often the result of clerical error. Identification is critical because of the high probability of a second patient receiving the wrong blood product at the same time.
• Treatment depends upon the type of transfusion reaction. Although pretransfusion prophylactic paracetamol and diphenhydramine are often routinely administered, there is little evidence to support this practice.