2. Introduction
• Adverse reactions to blood components
occurs despite multiple tests, checkups, &
inspections.
• Many reactions are not life threatening &
serious reactions present with mild symptoms
and signs.
3. Classification
• Classified based on etiology.
1. Immune mediated reactions.
2. Non immune mediated reactions.
3. Infectious complications.
10. GVHD
• Allogenic stem cell transplantation.
• TAGVHD-donor lymphocytes recognise host HLA
antigens as foreignimmune response.
• CF: fever, diarrhea, cutaneous eruption, liver
function abnormalities.
• Marrow aplasia, pancytopenia.
• Rx: highly reistant to immunospressive therapies,
glucocorticoids, cyclosporine, anti thymocyte
globulin, ablative therapy, allogenic bone marrow
transplantation.
11. Cont…
• CF: appear 8-10 days, death occurs-3-4 weeks
post transfusion.
• Prevention: irradiation-cellular components-
2500cGy.
• Risk-fetuses-intrauterine transfusions,
immuno compromised pt. lymphoma pt.
• Blood relatives-blood donation-discouraged.
• If, no other option, always irradiated.
12. TRALI
• Presents as acute respiratory distress either
during or with in 6hrs. of transfusion.
• CF: respiratory compromise, non cardiogenic
pulmonary edema.
• CXR: bilateral interstitial infiltrates.
• Anti HLA antibodies against recepient leukocytes.
• Dx: testing donor plasma for anti-HLA antibodies.
• Rx: supportive, recovery without sequle.
13. Posttransfusion purpura:
• Thrombocytopenia- 7 to 10 days after
transfusion.
• Platelet specific antibodies-recepient serum.
• Antigen-HPA-1a on platelet glycoprotein 3a
receptor.
• Rx: IV immunoglobulin, plasma pheresis.
14. Alloimmunization
• Women of child bearing age group who are
sensitized to RBC antigens[D, E, kell or duffy].
• HDNB.
• Dx: matching for D antigen is the only pre
transfusion selection test to prevent RBC
alloimmunization.
• Rx: leukoreduction of cellular components.
17. • Iron overload:
• Each RBC unit contains 200-250 mg iron.
• After 100 units of transfusion, CF of iron
overload as endocrinological, hepatic, cardiac
are common.
• Prevention: erythropoietin as alternate
therapy
• Hypotensive reactions: pt. using ACE
inhibitors.
• Bradykinin is degraded by ACE.
• No intervention needed.
18. Infectious complications
• Viral: HCV – common, asymptomatic to
chronic active hepatitis.
• HIV-1—HIV-1, p24 antigen—detected by NAT.
• HBV—risk of transmission is more than HCV.
• Vaccination-for long term transfusion therapy.
• West nile virus-asymptomatic to fatal.
• HTLV-1T- cell leukemia, lymphoma.
19. • Bacterial: relative risk is more than viral.
• Yersinia,
pseudomonas,serratia,escherichiacan grow
in cold temperatures.
• CF:fever, chills, progress to septic shock&DIC.
• Endotoxins-culprits.
• Rx: stop, reversing shock, broad spectrum
antibiotics.
• Other infectious agents: malaria, chagas
disease, babesiosis,dengue.