Complications and Risks of Blood Transfusions

8/4/2019 Complications and Risks of Blood Transfusions

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Tarek ABDULLAH alnizamiId:08090149

Complications and Risks of Blood

Transfusions


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Blood transfusion is the process of transferring blood or blood-basedproducts from one person into the circulatory system of another. Bloodtransfusions can be life-saving in some situations, such as massive

blood loss due to trauma, or can be used to replace blood lost duringsurgery.

Blood transfusions may also be used to treat a severe anemia orthrombocytopenia caused by a blood disease. People suffering fromhemophilia or sickle-cell disease may require frequent bloodtransfusions. Early transfusions used whole blood, but modern medicalpractice commonly uses only components of the blood.


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Most transfusions are not associated with any form of reactions.However, reactions can occur with any blood component. The reactionmay occur at the time of the transfusion, such as (febrile reaction) or

the destruction of the transfused red cells (hemolytic reaction).

Other effects, such as the transmission of viruses, are not apparent untilweeks or months later, after the incubation period and the onset of thedisease.


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The symptoms of most of the reactions include:

the development of a fever, chills, nausea

pain at the site of the transfusion (arm vein) .

shortness of breath.

a drop in blood pressure.

passing dark or red urine.

skin rash.

Serious complications can be prevented by early recognition of a reaction,

stopping the transfusion and limiting the amount of blood given.


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Risks of Transfusion

a. Transfusion Reactions

a. Transmission of Infections

a. Immunomodulation

a. Transfusion-associated acute lung injury

a. Graft Versus Host Disease


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Transfusion Reaction NonHemolytic

Febrile Reaction (The most common)

caused by cytokines from leukocytes in transfused red cell or plateletcomponents

Chills, Fever

Headache, Sweatiness

15min-1hr

Anaphylactic Reaction orAllergic reactions (in people with IgAdeficiency)

Urticaria

Abdominal cramps

Dyspnea, Vomiting, Diarrhea


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Treatment

Stop Transfusion

Give AntiHistamines

Administer epinephrine/ corticosteroid

Support airway and circulation as necessary


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Transfusion Reaction Hemolytic

most commonly due to the administration of mismatched blood types.

Acute Reaction

Burning at the intravenous (IV) line site

Fever, Chills, Dyspnea

Cardiovascular Collapse & Shock

Hemoglobinuria, Hemoglobinemia

Renal Failure

DIC (Disseminated intravascular coagulation)

Delayed Reaction

Fever


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Treatment

Stop Transfusion immediately

Check the name, type and crossmatch

Urine Exam

Renal Protection

DIC Monitor


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Transmission of Infections

Viruses

HIV, HBV, HCV, Cytomegalovirus (CMV)

Bacteria

E.coli, Yersinia

Parasites

Malaria


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Immunomodulation

The transfusions can cause decreases in immune function. The medical

term for this effect is immunomodulation. It is not clear what theimplications of this effect.

Immunosuppressive effect of Transfusion

Mediated by WBCs


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Transfusion-associated acute lung injury

TRALI is a syndrome of acute respiratory distress, often associated withfever, non-cardiogenic pulmonary edema, and hypotension, which mayoccur as often as 1 in 2000 transfusions.

Symptoms can range from mild to life-threatening, but most patientsrecover fully within 96 hours, and the mortality rate from this conditionis less than 10%.


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Graft Versus Host Disease

Donor white cells (lymphocytes) can attack the recipients skin, liver,bowel and marrow after blood or marrow stem cell transplantation.

Although this is very uncommon, it may happen in patients whohave decreased immune system function, referred to asimmunosuppressed or immunocompromised.

The symptoms include low blood pressure and fever. It is also lifethreatening.


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Massive Transfusion

Replacement of patients blood volume OR 10 units infew hours

RISKS

Volume overload

Acid Base disturbance

Hypocalcemia

Coagulopathy ----


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Thank you

for your attention

Complications and Risks of Blood Transfusions

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