Transfusion reaction
小结
Definition
History and exam
Key diagnostic factors
- chills
- flushing
- dyspnea
- fever
- chest, abdominal, flank, and back pain
- hypotension
- bleeding from mucous membranes, GI tract, or urinary tract
Other diagnostic factors
- headache
- nausea and vomiting
- anxiety
- pain along the infused extremity
- pruritus
- urticaria
- angioedema
- jaundice
- rales
- red urine
- stridor or bronchospasm
- pallor
- maculopapular rash
- diarrhea
- disseminated purpura
- exfoliative dermatitis with mucocutaneous involvement
Risk factors
- prior pregnancy
- previous transfusion
- history of transplantation
- IgA deficiency
- immunocompromise
- history of transfusion reaction
Diagnostic tests
1st tests to order
- direct antiglobulin test
- visual inspection of post-transfusion blood sample
- repeat ABO testing on post-transfusion blood sample
- post-transfusion urinalysis
Tests to consider
- serum IgA levels
- anti-IgA antibody testing
- serum tryptase level
- serum alloantibody screen
- serum LDH
- serum bilirubin
- gram stain and culture of component and post-transfusion recipient samples
- biopsy of skin, gut or liver
- HLA typing
- platelet antibody screen
- serum haptoglobin
- serum potassium
- serum bicarbonate
- serum calcium
- serum creatinine
- CBC
- D-dimer
- PT and PTT
- chest x-ray
- arterial blood gas
Treatment algorithm
acute transfusion reaction
delayed transfusion reaction
Составители
Авторы
Dih-Dih Huang, MD
Department of Surgery
St. Joseph’s Hospital and Medical Center
Phoenix
AZ
Раскрытие информации
DH declares that she has no competing interests.
Выражение благодарностей
Dr Dih-Dih Huang would like to gratefully acknowledge Dr Jordan A Weinberg, previous contributor to this topic.
Раскрытие информации
JAW declares that he has no competing interests.
Рецензенты
Erin Horstman, MD
Assistant Professor of Laboratory Medicine
Yale University
New Haven
CT
Раскрытие информации
EH declares that she has no competing interests.
Christoph Pechlaner, MD
Associate Professor of Medicine
Innsbruck Medical University
Innsbruck
Austria
Раскрытие информации
CP declares that he has no competing interests.
Marisa Marques, MD
Professor of Pathology
University of Alabama at Birmingham Hospital
Birmingham
AL
Раскрытие информации
MM declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Soutar R, McSporran W, Tomlinson T, et al. Guideline on the investigation and management of acute transfusion reactions. Br J Haematol. 2023 Jun;201(5):832-44.Полный текст Аннотация
Panch SR, Montemayor-Garcia C, Klein HG. Hemolytic transfusion reactions. N Engl J Med. 2019 Jul 11;381(2):150-62. Аннотация
Laureano M, Khandelwal A, Yan M. Canadian Blood Services. Clinical guide to transfusion: transfusion reactions (chapter 10). Oct 2022 [internet publication].Полный текст
American Red Cross. A compendium of transfusion practice guidelines: fourth edition. 2021 [internet publication].Полный текст
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Transfusion-associated sepsis
- Nonimmune-mediated hemolysis
- Transfusion-associated circulatory overload (TACO)
Больше ОтличияРекомендации
- Canadian Blood Services clinical guide to transfusion
- Prevention of transfusion-associated graft-versus-host disease (TA-GVHD)
Больше Рекомендации
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