Non-Infectious Transfusion Complications: Learning Objectives
Medical Importance
Transfusion of serologically incompatible blood can cause acute or delayed hemolytic transfusion reactions or hemolytic disease of the newborn. Fatal complications of blood collection or transfusion must legally be reported to the Food and Drug Administration. About 1/3 of these deaths are estimated to have been preventable. The major preventable cause of transfusion-related death is acute hemolytic transfusion reaction due to ABO incompatibility. Transfusion related graft vs. host disease is uncommon but has a mortality >95 percent. It is completely preventable with irradiation. Physicians must foster vigorous and vigilant prevention of serious transfusion reactions, and must ensure prompt recognition and treatment.
Objectives
- Be able to list the major clinical effects of intravascular hemolytic transfusion reactions.
- Be able to identify the most effective method known to prevent the majority of acute hemolytic transfusion reactions.
- Be able to list the clinical symptoms and laboratory findings of delayed hemolytic transfusion reactions.
- Be able to name three major clinical situations in which Rh Immune Globulin should be given to prevent HDN.
- The most common reaction to transfused blood, particularly red cells and platelets, is fever. Be able to name two adverse consequences of transfusion that may first manifest themselves with fever.
- Know the clinical presentation of Transfusion-Associated Acute Lung Injury (TRALI) and what causes it.
- Be able to explain what transfusion-associated graft-versus-host disease is, who is at risk, and how to prevent it.