7. General complication of transfusion.
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Generally, transfusion of incompatible blood components, posttransfusion reactions and
transmission of infectious and virus diseases from a donor to a recipient are key
complications of transfusion that must be mitigated and assessed prior to the transfusion .
It is also important to be cautious with transfusion in a patient who is unconscious state or
under narcosis, as the occurrence of the reaction or complications can include causeless
cardiac acceleration and hypotension
Generally the key complications include Disturbance of hemodynamic, Homolysis and
Haematuria.
Greater details regarding transfusion complication :
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Acute hemolytic transfusion reactions
o occur when ABO-incompatible blood is transfused, resulting in recipient
antibodies attaching to donor RBC antigens and forming an antigen-antibody
complex
Delayed hemolytic transfusion transfusion reactions
o Occurs because of incompatibility of minor antigens and are characterized by
extravascular hemolysis. They present 2 days to months after transfusion.
Febrile nonhemolytic transfusion reactions
o most common transfusion reactions. They occur when anti-leukocyte
antibodies in a recipient react with white blood cells in a transfused blood
product
Allergic transfusion reactions
o are common and arise from recipient antibody response to donor plasma
proteins.
Transfusion-Related Acute Lung Injury (TRALI)
o This is a condition of severe pulmonary insufficiency following blood, and
other forms of transfusion .
TACO (transfusion-associated circulatory overload)
o condition of circulatory congestion secondary to the fluid volumes
administered as transfusion
Graft-Versus-Host Disease (GVHD)
o rare and almost always fatal complication of blood transfusions resulting from
an attack of immunocompetent donor lymphocytes on the host’s various
tissues.
Coagulopathy
o Massive transfusion of RBCs may lead to a dilutional coagulopathy, as
plasma-reduced RBCs contain neither coagulation factors nor platelets.
Hypothermia
o Red blood cells are stored at 4 degrees Celsius. Rapid transfusion at this
temperature will quickly lower the recipient’s core temperature and worsen
impair hemostasis. This reduction in temperature can be minimized by
warming all I.V. fluids and by the use of forced air convection warming
blankets to reduce radiant heat loss.
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Bacterial and Viral Infections
o contamination of blood components is an complication of transfusion leading
to sepsis. It can result from contamination during venipuncture or if a
symptomatic donor is bacteremic or viremic at the time of donation.
Air Embolism
o The incidence of air embolism has now reduced markedly with the use of
plastic blood bags. Nevertheless, air can enter a central catheter while blood
administration sets or blood bags are being changed or if blood in an open
system is infused under pressure.
Transfusion associated immunomodulation
o The incidence of air embolism has now reduced markedly with the use of
plastic blood bags. Nevertheless, air can enter a central catheter while blood
administration sets or blood bags are being changed or if blood in an open
system is infused under pressure.