Transfusion Transmitted Reaction.pptx

Transfusion Transmitted Reaction.pptx

• 1.
  Dr. sandeep singh NSCGMCKhandwa Transfusion Transmitted Reaction
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   Transfusion reactionare generally classified into 2 types- 1.Immune- Immunological reactions may be against RBC, Leucocytes, platelets and immunoglobins. 2.Non-immune- non-immune transfusion reaction include circulatory overload, massive transfusion or transmission of an infectious agents.
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  Immunological transfusion reaction Immediate TR (min or hours) 1. Hemolytic 2. Febrile nonhemolytic 3. Allergic 4. TRALI  Late TR (days, years) 1. Hemolytic 2. Allo-immunisation 3. Post transfusion purpura 4. GVHD 5. Immune modulation
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   Acute hemolytictransfusion reaction-  Pathophysiology- RBC mismatch between donor and recipient  C/F- fever, chills/ rigors, back pain, hypotension, hemoglobinuria, pain along IV line, bleeding diathesis
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   Febrile nonhemolytictransfusion reaction-  Pathophysiology- cytokines in blood unit.  c/f- Rise in temperature, chills/ rigors. Discomfort, vomiting and flushing
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   Allergic-  Pathophysiology-recipient’s IgE react with donor plasma protein leading to release of mast cell mediators.  c/f- pruritus, urticaria or flushing.
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   Anaphylactic-  Pathophysiology-antibodies to donor plasma protein including IgA , haptoglbins, complements, ethylene oxide.  c/f- hypotension , urticaria, bronchospasm, stridor, local edema.
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   Transfusion relatedlung injury-  Pathophysiology- leucocytes antibodies in donor or recipient  c/f hypoxemia, noncardiogenic pulmonary edema, respiratory failure, hypotension, fever, cynosis.
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   Delayed hemolytictransfusion reaction-  c/f- fever, decreasing hematocrit, mild icterus with other features of hemolysis.  Alloimmunization-  Pathophysiology- immune response to red cells, platelets, leucocytes antigens refractoriness  c/f- hemolytic disease of fetus and newborn, delayed serologic reaction
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   Translation associatedimmunomodulation-  Allogenic leucocytes or their soluble products  c/f increased chances of postoperative infections, cancer recurrence, multiple organ dysfunction  Transfusion associated graft versus host disease-  c/f rashes, watery diarrhoea, fever, anorexia, vomiting abnormal LFT , bone marrow failure
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   Post transfusionpurpura-  Antibodies against platelet specific antigens  c/f thrombocytopenia, purpura, bleeding
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  NON IMMUNE TRANSFUSIONREACTIONS  Transfusion related sepsis-  Blood product contaminated with bacteria  c/f fever, chills, hypotension within 90 min of transfusion  Non immune hemolysis-  Physical/ mechanical/ chemical destruction of blood  Features of intravascular hemolysis of red cells, hemoglobinuria, hemoglobinemia
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   Transfusion associatedcirculatory overload  c/f signs of CCF , shortness of breath, wheezing, hypotension  Air embolism-  Air infusion via IV line  Sudden dyspnoea, acute cyanosis, shoulder or back pain, cough, hypotension