1. Adverse Effects of Blood Transfusion By Dr G.P.Saluja Consultant Blood Bank Alchemist Hospital

5. Immediate and Delayed Transfusion Reaction 30/11/2549 MD-3 /49 Acute(Immediate) and Delayed Transfusion Reactions Immediate Delayed Immune Effects AHTR DHTR FNHTR Alloimmunization Allergic reaction PTP Anaphylaxis & anaphylactoid reaction TA-GVHD NCPE Immunosuppression Nonimmune Effects Bacterial contamination Iron overload TACO TTV Physical RBC damage Depletion & dilution of coagulation factors and platelets

12. 30/11/2549 MD-3 /49 Management DIC ( Disseminated intravascular coagulation ) FFP Platelets Cryoprecipitate Heparin Acute hemolytic rxns Acute Hemolytic Rxns

45. Citrate Toxicity Mild Moderate Severe Paresthias: -Perioral (Lips) -Peripheral (Fingertips) Lightheadedness Frank Tetany Muscle Cramps Laryngeal Spasm Weakness Seizures Chills Nausea Arrhythmia Shivering Vomiting Prolonged QT Interval “ Crawling Feeling” Chest Pain Bradycardia

50. Clinical presentation Symptoms include Pyrexia low grade and Chills. Unexpected Falling HCT, slight increase in indirect bili, spherocytes on blood smear Diagnosis New +DAT and new Ab screening test when new blood is ordered Treatment None in the absence of rapid hemolysis Avoid offending Ag in future tranx Delayed Hemolytic Txn Rxn

56. Pathophysiology Infusion of Immuno-competent Cells (Lymphocyte) ↓ Patient at risk ↓ proliferation of donor T lymphocytes ↓ attack against patient tissue Patho-physiology Transfusion associated Graft Versus-Host Disease(Ta-GVHD)

68. Transfusion transmitted diseases SEROLOGICAL TESTING HIV - Ag HIV - Ab HBsAg Anti-HCV Malaria Ag Antibodies to Treponema Pallidum(Syphilis)

69. Transfusion transmitted diseases Estimated risk of transfusion transmitted infection Virus and testing standard Window Period (Days) Point estimate of residual risk 'per unit' HIV 1 and 2 antibody only 22 1 in 2,404,000 1 in 7,299,000 HIV antibody + NAT 9 HCV antibody only 66 1 in 330,000 1 in 3,663,000 HCV antibody + NAT 7 HBV 45 1 in 1,339,000

71. Concusion

73. TAKE CARE YOUR PATIENTS WITH BLOOD TRANSFUSION