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Alternative namesBlood transfusion reaction
DefinitionTransfusion reaction is a complication of blood transfusion where there is an immune response against the transfused blood cells or other components of the transfusion.
Causes, incidence, and risk factors
The immune response normally protects the body from potentially harmful substances. These substances ( antigens ) trigger multiple responses, including production of antibodies (immunoglobulins, molecules that attach to a specific antigen and aid in its destruction), and sensitized lymphocytes that recognize a particular antigen and destroy it.
The immune system normally can distinguish its own blood cells from other cells. These foreign proteins (antigens) produce an immune response.
Blood is classified according to the presence of these antigens, resulting in blood types A, B, AB (contains both antigens), and O (contains neither antigen). Blood plasma contains antibodies against the opposite antigen. A person with Type A blood, for example, has antibodies against the B antigen.
People with Rhesus factors in their blood are classified as "Rh positive," while persons without the factors are classified as "Rh negative." Rh negative persons form antibodies against the Rh factor if they are exposed to Rh positive blood.
This is of major importance in an Rh negative mother who is pregnant with an Rh positive baby. There are other antigens as well, besides ABO and Rh antigens.
These components also cause a similar type of transfusion reaction. Alternatively, antibodies in the transfused blood can bind the patient's own blood cells, also causing a reaction.
Signs and testsSymptoms of transfusion reaction usually appear during or immediately after the transfusion. Occasionally, they may develop after several days (delayed reaction). Symptoms may remain mild or progress to kidney failure , delayed anemia , or shock .
This disease may also alter the results of the following tests:
TreatmentThe goal of treatment is to prevent or treat severe effects of transfusion reaction. If symptoms occur during the transfusion, the transfusion is stopped. Blood samples from the person receiving the transfusion (and from remaining donor blood) may be tested to confirm that symptoms are caused by transfusion reaction.
Mild symptoms may be treated according to the symptom. Antihistamines such as diphenhydramine may reduce itching and rash. Acetaminophen may be recommended to reduce fever and discomfort. Corticosteroids such as prednisone or dexamethasone may be given to reduce the immune response. Intravenous fluids and various medications may be used to treat/prevent kidney failure and shock.
Expectations (prognosis)The outcome varies depending on the severity of the reaction. The disorder may disappear completely and without problems. However, it may be severe and life threatening.
Calling your health care providerNotify your health care provider if a blood transfusion is planned and previous transfusion reaction has occurred.
PreventionTyping of donated blood into ABO and Rh groups has reduced the risk of transfusion reaction.
Prior to a transfusion, blood is usually crossmatched to further confirm that the blood is compatible. A small amount of donor blood is mixed with a small amount of recipient blood and the mixture is examined under a microscope for signs of antibody reaction.
Update Date: 6/5/2003Ezra E. W. Cohen, M.D., Section of Hematology/Oncology, Department of Medicine, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT