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Definition

A hemolytic transfusion reaction is a serious problem that occurs after a patient receives a transfusion of blood. The red blood cells that were given to the patient are destroyed by the patient's own immune system.

Alternative Names

Blood transfusion reaction

Causes, incidence, and risk factors

Blood is classified into different blood types called A, B, AB, and O.

The immune system normally can tell its own blood cells from blood cells from another person. If other blood cells enter your body, your immune system may make antibodies again them. These antibodies will work to destroy the blood cells that the body does not recognize. For example, a person with type A blood makes antibodies against type B blood cells.

Another way blood cells may be classified is by Rh factors. People who have Rh factors in their blood are called "Rh positive." People without these factors are called "Rh negative." Rh negative people form antibodies against Rh factor if they receive Rh positive blood.

There are also other factors to identify blood cells, in addition to ABO and Rh.

Blood that you receive in a transfusion must be compatible. Being compatible means that your body will not form antibodies against the blood you receive. Blood transfusion between compatible groups (such as O+ to O+) usually causes no problem. Blood transfusion between incompatible groups (such as A+ to O-) causes an immune response. This can lead to a very serious transfusion reaction. The immune system attacks the donated blood cells, causing them to burst.

Today, all blood is carefully screened. Modern lab methods and many checks have helped make these transfusion reactions very rare.

Symptoms

Symptoms of transfusion reaction usually appear during or right after the transfusion. Sometimes, they may develop after several days (delayed reaction).

Signs and tests

This disease may change the results of these tests:

Treatment

Therapy can prevent or treat the severe effects of a hemolytic transfusion reaction. If symptoms occur during the transfusion, the transfusion is stopped immediately. Blood samples from the person getting the transfusion and from the donor may be tested to tell whether symptoms are being caused by a transfusion reaction.

Mild symptoms may be treated with the following:

  • Antihistamine drugs (such as diphenhydramine) can treat itching and rash.
  • The pain reliever, acetaminophen can reduce fever and discomfort.
  • Corticosteroids (such as prednisone or dexamethasone) can reduce the immune response.
  • Fluids given through a vein (intravenous) and other medications may be used to treat or prevent kidney failure and shock.
Expectations (prognosis)

The outcome depends on the severity of the reaction. The disorder may disappear without problems. Or, it may be severe and life threatening.

ComplicationsCalling your health care provider

Tell your health care provider if you are having a blood transfusion and you have had a reaction before.

Prevention

Donated blood is put into ABO and Rh groups to reduce the risk of transfusion reaction.

Before a transfusion, patient and donor blood is tested (crossmatched) to see if it is compatible. A small amount of donor blood is mixed with a small amount of patient blood. The mixture is checked under a microscope for signs of antibody reaction.

Before the transfusion is given, the health care provider will usually check again to make sure you are receiving the right unit of blood.

References

Goodnough L. Transfusion medicine. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 183.

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Related Questions

Is a serious and potentially fatal complication that occurs when the patient's blood and the donated blood do not match?

Acute immune hemolytic reaction


What is the possible cause of death in a blood transfusion?

These complications may include an acute hemolytic transfusion reaction (AHTR), which is most commonly caused by ABO incompatibility. The patient may complain of pain, difficult breathing, fever and chills, facial flushing, and nausea.


What will happen to a person if they are o blood type and receive b blood?

An acute hemolytic transfusion reaction, with possible acute renal failure and death.


What are the hazards of incompatible blood transfusion?

Risks associated with autologous blood transfusion include transfusion reaction if an allogeneic blood transfusion was inadvertently given and transmission of infectious agents if the blood became contaminated.


What is a hemolytic reaction to a blood transfusion?

Most severe type, but rare incompatible blood incompatibility in multiple transfusions. Mostlikely to occurs when transfused red cells react with circulating antibody in the recipient with resultant intravascular hemolysis. When a group O patient is mistakenly transfused with group A, B, or AB blood. Patients receiving a major ABO- incompatible marrow or stem cell transplant with sufficient red cell content will likely develop an acute hemolytic reaction. Symptoms are: fever, chills and fever, the feeling of heat along the vein in which the blood is being transfused, pain in the lumbar region, constricting pain in the chest, tachycardia, hypotension, and hemoglobinemia with subsequent hemoglobinuria and hyperbilirubinemia. Prevention: proper identification of patients, pre-transfusion blood samples and blood components at the same time of transfusion.


Can the kell blood system be the cause of a hemolytic transfusion reaction or hemolytic disease of the newborn?

Yes, although ABO and Rh are the main causes of haemolytic transfusion reactions (HTR's), if a person with an anti-K antibody is transfused with red blood cells which have a kell antigen on their surface, it has been known to cause delayed HTR's through the supression of erythropoiesis. As for haemolytic disease of the newborn, it is thought that anti-K can cause HDN vie anaemia, not jaundice.


How could robert be liable for mislabeling blood samples?

Mislabeling of blood specimens can result in hemolytic transfusion reactions from the incompatible blood.


What can happen if you mix the wrong blood type?

Mixing the wrong blood type during a transfusion can lead to a serious and potentially life-threatening reaction known as hemolytic transfusion reaction. This occurs when the recipient's immune system attacks the transfused blood cells, leading to the destruction of these cells. Symptoms can include fever, chills, back pain, dark urine, and in severe cases, shock or organ failure. Prompt medical intervention is crucial to manage the reaction and prevent complications.


What is likely to happen to a donor's cells if an Rh person who is sensitive Rh plus blood receives a transfusion of Rh plus blood?

If a donor's Rh-negative cells are transfused into an Rh-positive recipient, the recipient's immune system may recognize the Rh antigens as foreign and mount an immune response, leading to destruction of the donor's red blood cells. This can result in a reaction called hemolytic transfusion reaction.


What are the risks associated with receiving a blood transfusion?

Sometimes problems occur with a blood transfusion, but that is supposed to be rare. Some people can have an allergic reaction to the transfusion.


Is a transfusion reaction a subacute hypersensitivity to foreign red blood cells?

A transfusion reaction is typically an acute hypersensitivity reaction to foreign red blood cells, which can occur immediately or within a few hours of the transfusion. Subacute hypersensitivity reactions usually take days to develop after exposure to the antigen, unlike the immediate onset of symptoms seen in transfusion reactions.


What is anti jka?

Anti-Jka is an antibody that targets the Jk(a) antigen found on the surface of red blood cells. It is part of the Kidd blood group system, and its presence can lead to hemolytic transfusion reactions or hemolytic disease of the newborn if a person with anti-Jka receives Jk(a)-positive blood. Testing for anti-Jka is important in blood transfusion compatibility and prenatal care.