What are the major blood types?
Although a number of blood groups are identified based on the antigens present on the surfaces of red blood cells, the ABO blood group system is the most important. Group A cells have the A antigen and naturally occurring anti-B antibodies in the plasma. Group B cells have the B antigen and naturally occurring anti-A antibodies. Group AB cells have both A and B antigens and neither anti-A nor anti-B antibodies in the plasma. Group O cells have neither A nor B antigens on their surfaces and therefore have both anti-A and anti-B antibodies.
What is the Rh factor?
The Rh grouping system's most common antigen is the D antigen. This system uses (+) and (–) symbols to indict the presence (+) or absence (–) of the D antigen. Approximately 85% of the population is Rh positive and 15% of the population is Rh negative.
What are the characteristics of an anaphylactic transfusion reaction?
An anaphylactic transfusion reaction is an acute immunological reaction that occurs in a patient. The reaction usually takes place within 45–120 seconds from when the transfusion was first started. Symptoms may include anxiousness, irritability, wheezing, local edema arm, severe hypotension, nausea, abdominal cramps, cough, bronchospasm, laryngospasm, urticaria, shock, and/or loss of consciousness. This reaction can lead to a fatal event. This is a relatively rare type of transfusion reaction.
What are the characteristics of a bacterial transfusion reaction?
A bacterial transfusion reaction occurs when contamination by bacteria takes place during the blood collection, processing, or storage of the blood product. This type of reaction usually takes place within 5–60 minutes from when the transfusion was started. Symptoms may include fever, chills, a body temperature 1–2 °C above the normal, a 20 mmHg or greater decrease from pre-transfusion blood pressure, renal failure, and/or shock. This is a relatively rare type of transfusion reaction.
What are the characteristics of a delayed hemolytic transfusion reaction?
A delayed hemolytic transfusion reaction occurs when a patient has a relatively small number of antibodies present from a previous transfusion or pregnancy that go undetected in traditional pre-transfusion testing procedures. When the patient is exposed to the corresponding RBC antigen again, an anamnestic response leads to increased antibody production whereby red blood cell destruction occurs due to the antibodies present. This type of reaction usually takes place 3–10 days after the transfusion. Symptoms may include decreased hemoglobin levels, slight yellow skin color, and a body temperature 1–2 °C above the normal. This is a type of transfusion reaction that occurs much more frequently than acute hemolytic transfusion reactions.
What are the characteristics of a febrile, non-hemolytic transfusion reaction?
A febrile transfusion reaction occurs when cytokines and antibodies to leukocyte antigens react with leukocytes or their fragments. A febrile reaction typically takes place within 240 minutes during the transfusion or 60–120 minutes post-transfusion. Symptoms may include chills, shaking, sweating, headache, nausea, a body temperature 1–2 °C above the normal, and approximately a 30 mmHg increase or decrease from normal blood pressure. This type of transfusion reaction occurs in approximately 1 in 8 transfusions. Giving leukoreduced units of blood has significantly decreased the frequency of this type of reaction.
What are the characteristics of a hemolytic transfusion reaction?
A hemolytic transfusion reaction occurs when transfused red blood cells react with antibodies in the patient, resulting in the destruction of the red blood cells. This is most often due to clerical errors, such as mislabeling blood products or patient blood type, and ABO incompatible blood is given in error. The most severe reactions are associated with transfused red blood cells that are ABO incompatible. This type of reaction usually takes place within 1–10 minutes from when the transfusion was started. Symptoms may include chills, back pain, pain at IV site, anxiousness, blood at IV site, a body temperature 1–2 °C above the normal, and a 20 mmHg or greater decrease from pre-transfusion blood pressure. This is a relatively rare type of transfusion reaction.
What are the characteristics of a TACO (transfusion associated circulatory overload) transfusion reaction?
A TACO transfusion reaction occurs when a patient's circulatory system is overloaded by blood products during a transfusion. A TACO reaction typically takes place within 240 minutes during the transfusion or 60–120 minutes post-transfusion. This reaction most often occurs in critically ill (about 0.1%) and orthopedic patients (about 3%). Symptoms may include headache, breathing difficulties with more than 20 bpm, coughing, slight blue skin color, a 30 mmHg or greater increase from pre-transfusion blood pressure, and tachycardia.
What are the characteristics of a TRALI (transfusion related acute lung injury) transfusion reaction?
A TRALI transfusion reaction occurs when antibodies in the donor plasma react with patient leukocyte antigens or other mediators in the circulatory system of the transfusion recipient. A TRALI reaction typically takes place within 240 minutes during the transfusion or 60–120 minutes post-transfusion. Symptoms may include breathing difficulties, shortness of breath and/or rapid breathing with 20 or more bpm, slight blue skin color, a body temperature 1–2 °C above the normal, and a 20 mmHg or greater decrease in pre-transfusion blood pressure. This is a relatively rare type of transfusion reaction. There are some clinical signs and symptoms of TRALI that resemble anaphylactic transfusion reactions, TACO, and transfusion-related sepsis.
What are the characteristics of an urticaria or allergic transfusion reaction?
An urticaria transfusion reaction occurs when foreign plasma proteins in the donor react negatively with the recipient's blood. The reaction usually takes place within 45–120 seconds from when the transfusion was first started. Symptoms may include an itchy feeling and hives on the patient's face and/or arms. This type of transfusion reaction occurs in approximately 1% of all transfusions.
Blood transfusions can mean the difference between life and death for many patients. However, some patients exhibit negative reactions to transfusions that can be just as dangerous to their health as not receiving a needed transfusion. Can you observe the signs and symptoms of a patient post-transfusion to determine the type of negative reaction displayed?
