Pathology Cheat Sheet
Respond to a Transfusion Event
Transfusion safety for NEET-PG: transmitted infections, acute haemolytic reaction, febrile and allergic reactions, TRALI vs TACO, and autologous transfusion.
MedNext Academy | 3 min read
Respond to a Transfusion Event
Transfusion safety for NEET-PG: transmitted infections, acute haemolytic reaction, febrile and allergic reactions, TRALI vs TACO, and autologous transfusion.
Transfusion-transmitted infections, transfusion reactions and their investigation, and the principles of autologous transfusion.
High-yield lines
- Transfusion-transmitted infections include HIV, hepatitis B, hepatitis C, malaria, and syphilis, screened at donation.
- Acute haemolytic transfusion reaction is usually due to ABO incompatibility and causes fever, loin pain, and haemoglobinuria.
- Acute haemolytic reactions are a medical emergency requiring immediate stopping of the transfusion.
- Febrile non-haemolytic reactions are caused by recipient antibodies to donor leukocytes and cytokines.
- Allergic reactions cause urticaria and are due to plasma proteins, and severe anaphylaxis occurs in IgA-deficient recipients.
- Transfusion-related acute lung injury (TRALI) causes non-cardiogenic pulmonary oedema from donor anti-leukocyte antibodies.
- Transfusion-associated circulatory overload (TACO) is cardiogenic pulmonary oedema from volume overload.
- Delayed haemolytic reactions occur days later from an anamnestic antibody response to minor blood group antigens.
- Investigation of a transfusion reaction begins by stopping the transfusion and rechecking patient and unit identity.
- The direct Coombs test on a post-transfusion sample helps confirm immune haemolysis.
- Autologous transfusion uses the patient's own pre-donated blood to avoid alloimmunisation and infection.
- Leukoreduction of components reduces febrile reactions and cytomegalovirus transmission.
Mapped competency codes
- PA22.5
- PA22.6
- PA22.7
Continue into the full chapter
This summary maps to PA22-blood-banking-and-transfusion.
Frequently Asked Questions
What is the most dangerous acute transfusion reaction?
Acute haemolytic transfusion reaction, usually from ABO incompatibility, which causes fever, loin pain, and haemoglobinuria and requires the transfusion to be stopped immediately.
How do TRALI and TACO differ?
TRALI is non-cardiogenic pulmonary oedema from donor anti-leukocyte antibodies, while TACO is cardiogenic pulmonary oedema caused by circulatory volume overload.
What are the first steps in investigating a transfusion reaction?
Stop the transfusion immediately, maintain venous access, recheck the identity of the patient and unit, and send samples for a direct Coombs test and clerical check.
What is autologous transfusion?
Transfusion of the patient's own previously collected blood, which avoids alloimmunisation and transfusion-transmitted infection.
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