Bloody Minded Episode 34 - On the Wards: I would do anything for blood – but I won’t do that | Transfusion Reactions
Feb 4, 2025
Alison Chandler, a consultant haematologist, shares her expertise on managing transfusion reactions in a lively discussion. She explains the different types of transfusion reactions, emphasizing the importance of prompt identification and intervention. The conversation delves into the dangers of contaminated blood products and rare but serious reactions like TRALI. With engaging anecdotes and humorous insights from the ward, Chandler highlights essential protocols for patient safety, making a complex subject accessible and entertaining.
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Acute Hemolytic Transfusion Reaction
- Acute hemolytic transfusion reaction (AHTR) is caused by ABO incompatibility leading to massive hemolysis and complement activation.
- It can present very early with fever, hypotension, back pain, and hemoglobinuria.
Bacterial Contamination Risk
- Transfusion-associated bacterial infection is serious and most common with platelet transfusions due to room temperature storage.
- Patients develop sepsis-like symptoms including fever, rigors, hypotension, and tachycardia.
Transfusion-Associated Acute Lung Injury
- TRALI involves donor anti-neutrophil antibodies activating lung neutrophils causing capillary leak and hypoxia.
- It's a severe reaction occurring within six hours mainly due to plasma products or platelets.