hematology and oncology
Complications of Transfusion
Febrile nonhemolytic transfusion reaction
Febrile reactions may occur without hemolysis. Antibodies directed against white blood cell (WBC) human leukocyte antigen (HLA) in otherwise compatible donor blood are one possible cause. This cause is most common in multitransfused or multiparous patients. Cytokines released from WBCs during storage, particularly in platelet concentrates, are another possible cause. C, chills, and sometimes headache and back pain. Simultaneous symptoms of Allergic reactions are common. Because fever and chills also herald a severe hemolytic transfusion reaction, all febrile reactions must be investigated as for acute hemolytic transfusion reaction, as with any transfusion reaction. Most febrile reactions are treated successfully withacetaminophenand, if necessary,diphenhydramine. Patients should also be treated (eg, withacetaminophen) before future transfusions. If a recipient has experienced more than one febrile reaction, special leukoreduction filters are used during future transfusions; most hospitals use previously stored, leukoreduced (WBC-depleted RBCs) blood components. 