Acute Transfusion Reaction

Acute transfusion reactions occur as adverse symptoms and signs following a transfusion or within 24 hours. The most common, frequent reactions are chills, fever, urticaria or pruritus that typically resolves quickly without complications or treatment. Other signs, that may have a relationship with blood transfusion, is shortness of breath, high fever, red urine and loss of consciousness. These signs are an indication of severe, potentially fatal reaction.
Acute Hemolytic reaction is rare and has the symptoms of fever, chills, and feeling of heat in the vein where blood is being transfused. Others are: pain in the lumbar region, tachycardia, constricting pain in the chest and hyperbilirubinemia as well as hemoglobinuria (Murphy, Pamphilon & Heddle, 2013). Patients may report having feelings of impending doom. For the unconscious ones the only sign is a hemolytic transfusion reaction. A falling hematocrit is the most common sign of Delayed Hemolytic reaction. It is an uncommon reaction that occurs 4 to 8 days following a blood transfusion, but it can also develop one month later. Symptomatic patients manifest leukocytosis and fever, showing an occult infection. Febrile may also occur when cytokines and antibodies react with leukocyte fragments. It occurs in 1 of 8 infusions (Murphy et al., 2013). Allergic- urticarial occurs in 1% of the recipients of transfusions. The allergic reactions are associated with bronchospasm and laryngeal edema. The patient may also have the fever. The foreign plasma proteins cause the reaction. Allergic-Anaphylaxis has reactions
manifesting cardiovascular instability such as hypotension, loss of consciousness, tachycardia, cardiac arrhythmia and cardiac arrest. TRALI is a sudden onset of noncardiogenic pulmonary edema (Murphy et al., 2013). It is associated with the presence of antibodies present in the donor plasma that react with antigens. TRALI is rare, and most cases resolve after 72 hours. Bacterial contamination has the signs of fever, chills, shock respiratory distress, vomiting and nausea. It occurs when bacteria enter the blood during collection or processing of blood. Other adverse effects are hypotension, Graft vs. Host disease (GVHD), nonimmune hemolysis, and post-transfusion purpura (PTP).
In brief, each blood transfused has a small risk of either acute or later adverse effect.
The medical officers should carefully select patients to benefit from transfusion therapy following the established criteria. The most common adverse reactions are urticarial, chills and fever. The significant reactions are acute or delayed hemolytic transfusion reactions as well as bacterial contamination of
blood.