hematology and oncology
Complications of Transfusion
Allergic reactions
Allergic reactions to an unknown component in donor blood are common, usually due to allergens in donor plasma or, less often, to antibodies from an allergic donor. These reactions are usually mild and include urticaria, edema, occasional dizziness, and headache during or immediately after the transfusion. Simultaneous fever is common. Less frequently, dyspnea, wheezing, and incontinence may occur, indicating a generalized spasm of smooth muscle. Rarely, Anaphylaxis occurs, particularly in recipients with In a patient with a history of allergies or an allergic transfusion reaction, an antihistamine may be given prophylactically just before or at the beginning of the transfusion (eg,diphenhydramine50 mg orally or IV). NOTE:Drugs must never be mixed with the blood. If an allergic reaction occurs, the transfusion is stopped. An antihistamine (eg,diphenhydramine50 mg IV) usually controls mild urticaria and itching, and transfusion may be resumed. However, a moderate allergic reaction (generalized urticaria or mild bronchospasm) also requireshydrocortisone(100 to 200 mg IV), and a severe anaphylactic reaction requires additional treatment withepinephrine0.5 mL of 1:1000 solution subcutaneously and 0.9% saline IV along with investigation by the blood bank. Further transfusion should not occur until the investigation is completed. Patients with severe IgA deficiency require transfusion of washed RBCs, washed platelets, and plasma from an IgA-deficient donor. 