Complications and Risks of Blood Transfusions

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Tarek ABDULLAH alnizami Id:08090149

4/15/12

 Blood transfusion is the process of transferring blood or blood-based

products from one person into the circulatory system of another. Blood transfusions can be life-saving in some situations, such as massive blood loss due to trauma, or can be used to replace blood lost during surgery.

Blood transfusions may also be used to treat a severe anemia or

thrombocytopenia caused by a blood disease. People suffering from hemophilia or sickle-cell disease may require frequent blood transfusions. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood.

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 Most transfusions are not associated with any form of reactions.

However, reactions can occur with any blood component. The reaction may occur at the time of the transfusion, such as (febrile reaction) or the destruction of the transfused red cells (hemolytic reaction).

Other effects, such as the transmission of viruses, are not apparent until

weeks or months later, after the incubation period and the onset of the disease.

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The symptoms of most of the reactions include:

the development of a fever, chills, nausea pain at the site of the transfusion (arm vein) . shortness of breath. a drop in blood pressure. passing dark or red urine. skin rash.

Serious complications can be prevented by early recognition of a reaction, stopping the transfusion and limiting the amount of blood given.
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Risks of Transfusion
Transfusion Reactions

a.

a.

Transmission of Infections

a.

Immunomodulation

a.

Transfusion-associated acute lung injury

a.

Graft Versus Host Disease

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Transfusion Reaction Non Hemolytic

Febrile Reaction (The most common)

caused by cytokines from leukocytes in transfused red cell or platelet components Chills, Fever Headache, Sweatiness 15min-1hr

Anaphylactic Reaction or Allergic reactions (in people with IgA

deficiency) Urticaria Abdominal cramps Dyspnea, Vomiting, Diarrhea

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Treatment

Stop Transfusion Give AntiHistamines Administer epinephrine/ corticosteroid Support airway and circulation as necessary
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Transfusion Reaction Hemolytic

most commonly due to the administration of mismatched blood types.

Acute Reaction Burning at the intravenous (IV) line site Fever, Chills, Dyspnea Cardiovascular Collapse & Shock Hemoglobinuria, Hemoglobinemia Renal Failure DIC (Disseminated intravascular coagulation)

Delayed Reaction Fever 4/15/12

Treatment

Stop Transfusion immediately

Check the name, type and crossmatch

Urine Exam

Renal Protection

DIC Monitor 4/15/12

Transmission of Infections

Viruses HIV, HBV, HCV, Cytomegalovirus (CMV)

Bacteria E.coli, Yersinia

Parasites Malaria
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Immunomodulation

The transfusions can cause decreases in immune function. The medical

term for this effect is immunomodulation. It is not clear what the implications of this effect.

Immunosuppressive effect of Transfusion

Mediated by WBCs

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Transfusion-associated acute lung injury

TRALI is a syndrome of acute respiratory distress, often associated with

fever, non-cardiogenic pulmonary edema, and hypotension, which may occur as often as 1 in 2000 transfusions.

Symptoms can range from mild to life-threatening, but most patients

recover fully within 96 hours, and the mortality rate from this condition is less than 10%.

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Graft Versus Host Disease

Donor white cells (lymphocytes) can attack the recipients skin, liver,

bowel and marrow after blood or marrow stem cell transplantation.

Although this is very uncommon, it may happen in patients who

have decreased immune system function, referred to as immunosuppressed or immunocompromised.

The symptoms include low blood pressure and fever. It is also life

threatening.

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Massive Transfusion

Replacement of patients blood volume OR 10 units in few hours RISKS Volume overload Acid Base disturbance Hypocalcemia Coagulopathy ---4/15/12

Thank you for your attention

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