Table 3.
An overview of clinical features of important non infectious adverse blood transfusion reactions
| Type | Clinical features |
|---|---|
| Acute | |
| Immune mediated | |
| Acute haemolytic transfusion reaction | Fever, chills/rigors, back pain, hypotension, haemoglobinuria, pain along IV line, bleeding diathesis |
| Febrile nonhaemolytic transfusion reaction | Rise in temperature >1 °C, chills and/or rigors, discomfort, vomiting, flushing |
| Urticarial | Pruritus, urticaria, or flushing |
| Anaphylactic | Hypotension, urticaria, bronchospasm, stridor, local oedema |
| Transfusion related acute lung injury | Hypoxemia, noncardiogenic pulmonary oedema, respiratory failure, hypotension, fever, cyanosis |
| Non immune mediated | |
| Transfusion related sepsis | Fever ≥102 °F, chills, hypotension within 90 min of transfusion |
| Non immune haemolysis | Features of intravascular haemolysis of red cells, namely, haemoglobinuria, haemoglobinemia |
| Transfusion associated circulatory overload | Signs of congestive heart failure, shortness of breath, wheezing, hypertension |
| Delayed | |
| Immune mediated | |
| Delayed haemolytic transfusion reaction | Fever, decreasing haematocrit, mild icterus with other features of haemolysis |
| Alloimmunization to red cell antigens, platelets and leukocytes (HLA) | Haemolytic disease of fetus and newborn, delayed serologic reaction, platelet refractoriness |
| Transfusion associated immunomodulation | Increased chances of postoperative infections, cancer recurrence, multiple organ dysfunction |
| Transfusion associated graft versus host disease | Rash, watery diarrhoea, fever, anorexia, vomiting, abnormal liver function tests, bone marrow failure |
| Posttransfusion purpura | Thrombocytopenia, purpura, bleeding |
| Non immune mediated | |
| Iron overload | Diabetes, cardiomyopathy, cirrhosis |