Complications of blood transfusion

THE COMPLICATIONS OF BLOOD TRANSFUSION


The transfusion of blood and blood products are associated with certain risks and unfavorable effects (complications). Due to this, blood products should only be administered when alternate forms of therapy do not exist or are less effective. The side effects can be classified as follows:

1. IMMUNOLOGICAL:


 a. Due to red cell antibodies

        i) Sensitization to red cell antigens

       ii) Hemolytic transfusion reactions (Immediate and delayed)

b. Due to white cell antibodies

       i) Febrile transfusion reactions

       ii) Transfusion-related acute lung injury (TRALI)

       iii) Transfusion-associated graft versus host disease (TA GVHD)

Complications of blood transfusion, immunological and non immunological c. Due to platelet antibodies

      i) Platelet refractoriness

      ii) Post-transfusion purpura

d. Due to plasma protein antibodies

      i) Urticaria

     ii) Anaphylaxis

2. NON IMMUNOLOGICAL:


a. Transfusion-transmitted infections

    i) Viral

       (1) Hepatitis B Virus(HBV)

       (2) Hepatitis C Virus(HCV)

       (3) HIV 1 and 2

       (4) Cytomegalovirus (CMV)

       (5) HTLV I and II

       (6) Parvovirus B19

       (7) Epstein Barr (EB) virus

  ii) Protozoal

      (1) Malaria (Plasmodium spp.)

      (2) Chaga‘s disease (T.cruzi)

  iii) Bacterial

      (1) Syphilis (Treponema pallidum)

      (2) Yersinia enterocolitica

      (3) Pseudomonas spp.

      (4) Citrobacter, E.coli

      (5) Others

  iv) Prions

     (1) CJD (Creutzfeld-Jakob disease)

b. Circulatory overload

c. Citrate toxicity

d. Potassium toxicity

e. Acid overload

f. Thrombophlebitis

g. Air embolism

h. Transfusion haemosiderosis

    i). Complications of massive transfusions

    ii) Dilution of coagulation factors

    iii) Dilutional thrombocytopenia

    iv) Hyperkalaemia

     v) Hypocalcemia