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Chapter 39 - Reactions to Transfusions

Published online by Cambridge University Press:  21 February 2025

By
Patrick Maffucci ,
Lyle Nolasco ,
Marc Sherwin  and
Natalie Smith
Edited by
Dharti Patel ,
Sang J. Kim ,
Himani V. Bhatt  and
Alopi M. Patel
Dharti Patel
Affiliation:
Mount Sinai West and Morningside Hospitals, New York
Sang J. Kim
Affiliation:
Hospital for Special Surgery, New York
Himani V. Bhatt
Affiliation:
Mount Sinai West and Morningside Hospitals, New York
Alopi M. Patel
Affiliation:
Rutgers Robert Wood Johnson Medical School, New Jersey
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Summary

Transfusion of blood products can lead to a number of complications. In this chapter, the presentation, diagnosis, mechanism of action, incidence, treatment, and prevention of transfusion reactions are outlined. The reactions summarized in comparison with one another are febrile non-hemolytic, allergic, and hemolytic transfusion reactions. Other complications of transfusions, such as infections, immunosuppression, citrate intoxication, and acid–base and electrolyte abnormalities, are also explained, along with those associated with massive transfusions, such as coagulopathies and hypothermia. Pulmonary complications of transfusions, namely Transfusion-Related Acute Lung Injury (TRALI) and Transfusion-Associated Circulatory Overload (TACO), have been reviewed with the most up-to-date literature. The presentation, diagnosis, mechanism of action, incidence, treatment, and prevention of these two reactions are outlined, as well.

Keywords

Febrile Non-Hemolytic Transfusion ReactionAllergic Transfusion ReactionAcute Hemolytic Transfusion ReactionDelayed hemolytic transfusion reactionTransfusionHemolysisFNHTRATRAHTRDHTRHypersensitivity reactionRecipient antibodiesDonor antibodiesDonor leukocytesAlloantibodiesABO-incompatibilityMinor RBC antigendirect antiglobulin testDATLeukoreductionComplications of transfusionsTransfusion associated mortalityCitrate intoxicationMassive transfusionBlood storageComplications of massive transfusionTransfusion-Related Acute Lung InjuryTRALITransfusion-Associated Circulatory OverloadTACOTransfusion immunosuppressionTransfusion infection
Type
Chapter
Information
BASIC Essentials
A Comprehensive Review for the Anesthesiology BASIC Exam
 , pp. 215 - 221
Publisher: Cambridge University Press
Print publication year: 2025

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References

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