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Blood and Blood Product Transfusion Reaction

Blood and Blood Product Transfusion Reaction. History of blood group. In 1900, the German pathologist, Karl Landsteiner, identified 2 of antigenic proteins , which he called A and B

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Blood and Blood Product Transfusion Reaction

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  1. Blood and Blood Product Transfusion Reaction

  2. History of blood group • In 1900, the German pathologist, Karl Landsteiner, identified 2 of antigenic proteins, which he called A and B • In 1940, Dr. Landsteiner discovered another group of antigens. They were named Rhesus factors (Rh factors) because they were discovered during experiments on Rhesus monkeys • The surface of red blood cells contain several proteins that can be identified by the body as antigens

  3. Definition & Path physiology • Transfusion reaction is a complication of blood transfusion where there is an immune response against the transfused blood cells or other components of the transfusion

  4. ABO & Rh compatibility • Blood is classified according to the presence of these antigens: • Group A contains antigen A • Group B contains antigen B • Group AB contains both antigens • Group O contains neither antigen • Blood plasma contains antibodies against the opposite antigen: • A person with Type A blood has antibodies against the B antigen • A person with Type B blood has antibodies against the A antigen • A person with Type AB blood has no antibodies (Universal Recipient) • A person with Type O blood has antibodies against the A,B&AB antigens (Universal Donor)

  5. ABO & Rh compatibility • People with Rhesus factors in their blood are classified as "Rh positive" • People without the factors are classified as "Rh negative" • Rh negative persons form antibodies against the Rh factor if they are exposed to Rh positive blood • Conclusion: • Blood transfusion between incompatible groups causes an immuneresponse against the cells carrying the antigen, resulting in transfusion reaction

  6. Path physiology Immune system release antibodies Attach to a specific antigen and Cause its destruction Antigens enter the body Transfusion reaction occurred

  7. Symptoms • Fever • Chills • Rash • Flank pain or back pain • Bloody urine • Fainting or dizziness • Symptoms of transfusion reaction usually appear: • during transfusion • immediately after the transfusion • may develop after several days (delayed reaction)

  8. Complications   • Discomfort • Anemia • Acute kidney failure • Shock • Lung dysfunction

  9. IMMEDIATE INTERVENTION • If symptoms occur during the transfusion: • Stop the infusion • Give reaction medications if ordered • Inform the doctor • Order Transfusion Reaction Workup with the components: • Transfusion reaction • Direct coombs • Urine analysis • Send blood bag, tubing and the collected specimens to the blood bank • Fill blood transfusion reaction form • Documentation

  10. Medical Treatment • Antihistamines such as diphenhydramine to reduce itching and rash • Acetaminophen recommended to reduce fever and discomfort • Corticosteroids such as prednisone or dexamethasone to reduce the immune response • Intravenous fluids and various medications used to treat/prevent kidney failure and shock

  11. Prevention • Typing of donated blood into ABO and Rh groups has reduced the risk of transfusion reaction: • Prior to a transfusion, blood is usually crossmatched to further confirm that the blood is compatible • A small amount of donor blood is mixed with a small amount of recipient blood and the mixture is examined under a microscope for signs of antibody reaction • Give Rhogam which is a sterile solution containing IgG anti-D(RH1) for use in preventing Rh immunization

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