Acute Transfusion Reactions

Signs and symptoms Possible etiology Action Investigation

Dyspnoea, O2 saturation

With/without TACO (transfusion Stop transfusion Reaction form and group and
hypertension, associated circulatory Sit patient upright save (G&S)
tachycardia, signs overload) Chest X-ray may be helpful
Diuretics, O2
of fluid overload

With/without TRALI (transfusion-related Stop transfusion Reaction form and G&S

hypotension acute lung injury) Assess chest X-ray for HLA & HNA antibodies and
May become a infiltrates typing
medical emergency O2, possible intubation,
ventilation
Notify lab and Lifeblood

Bacterial contamination Stop transfusion Culture patient and product

or acute haemolytic Check patient ID with label Reaction form, G&S and DAT
transfusion reaction IV antibiotics if sepsis If haemolysis suspected – FBE,
May become a LDH, bilirubin, haptoglobin,
Maintain good urine output
medical emergency coags, electrolytes, urinalysis
Notify lab and Lifeblood for
bacterial contamination

transfusion.com.au Version 10.0 29 August 2019

Acute Transfusion Reactions
Signs and symptoms
Fever ( 38ºC and rise 1ºC) and/or chills, rigors
No other symptoms
Other symptoms present
(e.g. hypotension,
tachycardia)
or
≥ 39°C
Rash or urticaria (hives)
< 2/3 body
(no other symptoms)
> 2/3 body
(no other symptoms)
With dyspnoea, airway
obstruction, angioedema,
hypotension
This is a medical emergency
Possible etiology Action Investigation
Febrile non- Stop transfusion Reaction form to
haemolytic Exclude serious adverse events transfusion lab
transfusion reaction Antipyretics
Recommence if reaction subsides
Bacterial Stop transfusion Culture patient and product
contamination or Check patient ID with label Reaction form, G&S and DAT
acute haemolytic Initiate basic life support If haemolysis suspected –
transfusion reaction
IV antibiotics if sepsis FBE, LDH, bilirubin,
May become a Notify lab and Lifeblood for haptoglobin, coags,
medical emergency bacterial contamination electrolytes, urinalysis
Minor allergic Stop transfusion None
Antihistamine
Recommence if reaction subsides
Severe allergic Stop transfusion Reaction form
Antihistamine +/- corticosteriod
Anaphylaxis Stop transfusion Reaction form
(consider IgA Adrenaline Perform haptoglobin and
deficiency) Initiate basic life support IgA level and antibody