Types of transfusion reactions and their

causes
The following are the different types of transfusion reactions and what can cause them.

Febrile non-hemolytic reaction

This is one of the most common  types of transfusion reactions. It occurs during or up to
4 hours after a transfusion is completed.

Symptoms

fever
chills

Treatment

As always, the first step in managing a transfusion reaction is to stop the transfusion. The
symptoms are generally mild and respond well to treatment with antipyretics.

Acute hemolytic reaction

This occurs when antibodies in the recipient’s blood attack the donor’s blood if the two
are not compatible. The prevalence of an acute hemolytic reaction from a blood
transfusion is approximately 1 in 70,000 transfusions  .

Symptoms

fever
flank pain
red or brown urine
low blood pressure

Treatment

The first step is to stop the transfusion. From there, treatment is mainly supportive. If the
reaction is severe, in the case of low blood pressure, for example, aggressive
resuscitation should be initiated.

Allergic reaction
You can have an allergic reaction to a blood transfusion as well. This occurs when the
recipient’s immune system reacts to allergens or antigens in the donor’s blood. This type
of transfusion reaction could also progress into a more severe allergic reaction known as
anaphylaxis.

Symptoms

hives
itching
rash

Treatment

Again, the first step is to stop the transfusion. This reaction type is often treated  with
antihistamines. If you are experiencing more severe symptoms like trouble breathing or
swelling in your throat, your doctor may treat you with IV epinephrine, IV steroids, and
bronchodilators.

Transfusion-related acute lung injury (TRALI)

This reaction may occur  when donor plasma contains antibodies that cause damage to
the immune cells in the lungs. This lung damage results in fluid buildup in the lungs and
can severely limit the ability of the lungs to supply oxygen to the body. This reaction
usually occurs within six hours of receiving blood.

Symptoms

fever
shortness of breath
low blood pressure

Treatment

Immediate treatment is to stop the infusion. Supportive management is aimed at

improving oxygenation.

Septic
Sometimes, bacteria may be present in the donated blood. Giving this blood to a recipient
can lead to infection, shock, and death. Bacterial contamination is the second most
common  cause of blood transfusion-related deaths in the US. If not caught in time, it may
lead to sepsis.

Symptoms

fever
changes in blood pressure
stiffness

Treatment

Your doctor will treat you with IV fluids and a course of antibiotics for this transfusion
reaction.

Transfusion-associated circulatory overload (TACO)

A transfusion reaction can also occur if you receive too much blood. Having too much
blood can overload your heart, forcing it to work harder to pump blood through your body
and resulting in fluid buildup in the lungs. TACO and TRALI are the leading causes  of
transfusion-related deaths.

Symptoms

rapid heart rate

rapid breathing
shortness of breath
high blood pressure
bulging neck veins
low blood oxygen

Treatment

The first line of treatment is to stop the transfusion. Sitting upright may improve your
symptoms, or your doctor may need to administer IV diuretics in more severe cases.