Articles on Medical Diseases and Conditions

Entries for the ‘Undesirable Effects of Blood or Blood Product Transfusion’ Category

Massive Blood Transfusion

Massive blood transfusion is defined by the AABB as replacement of the patient’s blood volume (equivalent to 8-10 units of whole blood in a 70-kg person) within 12 hours (some define the time period as 24 hours). Transfusion of such volumes presents special difficulties, depending on the substance being transfused and the rate of administration. […]

Neonatal Transfusions

Besides many of the problems seen with adult transfusion, in neonates there are additional difficulties related to the small blood volume of the infant, the immaturity of the immune system and some of the enzyme systems, and the relatively high hematocrit level of the newborn. On the positive side, up to age 4 months the […]

Other Transfusion Problems

As noted in Chapter 9, concentrated immune gamma globulin (IV-GG) may contain red cell antibodies and also antibodies against various infectious agents such as hepatitis viruses, cytomegalovirus, and Epstein-Barr virus. Enough IV-GG may be transfused so that the transfused antibodies are detectable in recipient serum. This may cause problems in differential diagnosis of infection and […]

Infections Transmitted by Transfusion

Bacterial infection from contaminated blood or blood products is rare as long as continuous adequate refrigeration is provided. Platelets are especially apt to develop bacterial growth when stored at room temperature. The spirochetes of syphilis usually die after refrigerated storage for 4-5 days. Malaria could be transmitted in blood from infected travelers or immigrants from […]

Anaphylactic Reactions

Immunoglobulin A antigen reactions. Immunoglobulin A (Chapter 22)is the principal immunoglobulin in such human secretions as saliva, bile, and gastric juice. Class-specific anti-IgA occurs in patients who lack IgA; these persons may be clinically normal or may have such disorders as malabsorption syndrome, autoimmune disease, or recurrent sinus or pulmonary infection. Interestingly, only 40% develop […]

Tissue-Organ Immunologic Reactions

Graft-vs.-host disease (GVHD) Graft-vs.-host disease (GVHD) results from introduction of sufficient HLA-incompatible and immunologically competent donor lymphocytes into a recipient who is sufficiently immunodeficient that the incompatible donor cells cannot be destroyed. The donor lymphocytes proliferate and attack tissues of the new but incompatible host. There are two clinical types, organ transplants (represented here by […]

Cytopenic Reactions

Thrombocytopenia Blood platelets contain at least three antigen systems capable of producing a transfusion reaction. The first is the ABO (ABH) system, also found on RBCs; for that reason the AABB recommends that single-donor platelet units be typed for the ABO group before being transfused. Platelets do not contain the Rh antigen; however, since platelet […]

Allergic Reactions

Allergic reactions are the second most common transfusion reaction. They are presumably due to substances in the donor blood to which the recipient is allergic. Symptoms are localized or generalized hives, although occasionally severe asthma or even laryngeal edema may occur. There is usually excellent response to antihistamines or epinephrine.

Nonhemolytic Febrile Reactions

Sometimes called simply (and incorrectly) “febrile reactions,” nonhemolytic febrile reactions occur in about 1% (range, 0.5-5.0%) of all transfusions, more commonly in multiply transfused patients. Leukoagglutinin reaction. The most common variety of nonhemolytic febrile reaction and the most common of any transfusion reaction is a febrile episode during or just after transfusion due to patient […]

Jaundice in the Newborn or Neonate

Current consensus criteria indicating pathologic rather than physiologic levels of total bilirubin are the following: 1. Total bilirubin level over 5 mg/100 ml (88 µmol/L) in the first 24 hours. 2. Total bilirubin level over 10 mg/100 ml (171 µmol/L) during the second day of life, or an increase of 5 mg/100 ml per day […]