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Recognizing transfusion reactions is crucial for patient safety from "summary" of Hematology Board Review by Francis P. Worden, MD,Rami N. Khoriaty, MD,Kathleen A. Cooney, MD,Michael W. Deininger, MD, PhD

The recognition of transfusion reactions is essential for ensuring the safety of patients undergoing blood transfusions. These reactions can vary in severity, from mild to life-threatening, and can present with a wide range of symptoms. It is crucial for healthcare providers to be able to identify these reactions promptly and take appropriate action to prevent any harm to the patient. Transfusion reactions can be classified into two main categories: immune-mediated reactions and non-immune reactions. Immune-mediated reactions are caused by the recipient's immune system reacting to antigens present in the transfused blood. These reactions can manifest as hemolytic reactions, febrile non-hemolytic reactions, allergic reactions, or transfusion-related acute lung injury (TRALI). Non-immune reactions, on the other hand, are not caused by an immune response and can include transfusion-associated circulatory overload (TACO), sepsis, and iron overload. The signs and symptoms of transfusion reactions can vary depending on the type of reaction. Hemolytic reactions may present with fever, chills, back pain, hemoglobinuria, and hemodynamic instability. Allergic reactions can manifest as urticaria, pruritus, flushing, and respiratory symptoms. TRALI is characterized by acute respiratory distress and hypoxemia. TACO, on the other hand, presents with dyspnea, orthopnea, and evidence of volume overload. Prompt recognition of transfusion reactions is crucial for initiating appropriate management and preventing further complications. Healthcare providers should be vigilant in monitoring patients during and after transfusions and should be prepared to intervene quickly if a reaction occurs. Treatment may involve stopping the transfusion, providing supportive care, administering medications such as antihistamines or corticosteroids, and in severe cases, initiating advanced life support measures.
  1. Recognizing transfusion reactions is vital for ensuring the safety and well-being of patients undergoing blood transfusions. Healthcare providers should be knowledgeable about the different types of reactions, their clinical manifestations, and the appropriate management strategies to effectively respond to any adverse events that may occur during or after a transfusion.
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Hematology Board Review

Francis P. Worden, MD

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