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Hemolytic transfusion reactions are a possible complication from red blood cell transfusions. Hemolysis refers to the lysis (rupture) of red blood cells, and the resulting leakage of their contents. Hemolytic reactions may be immune or non-immune mediated. Immune-mediated hemolytic reactions, such as DHTR, represent a type of alloimmunity.
Febrile non-hemolytic transfusion reaction (FNHTR) is the most common type of transfusion reaction. It is a benign occurrence with symptoms that include fever but not directly related with hemolysis. [1] It is caused by cytokine release from leukocytes within the donor product as a consequence of white blood cell breakdown.
Delayed hemolytic transfusion reaction; F. Febrile non-hemolytic transfusion reaction; P. Platelet transfusion refractoriness; Post-transfusion purpura; S.
Among these, a potentially life-threatening reaction is known as a hemolytic transfusion reaction. This is an immune mediated reaction where recipient antibodies attack donor red blood cell antigen(s), causing hemolysis of donor cells. The reaction may occur during, immediately after, or up to 28 days later.
Kidd antibodies are dangerous as they are capable of causing severe acute hemolytic transfusion reactions. They are unique in that they are capable of dropping to low or even undetectable levels after several months following an exposure. [5] Thus, on pre-transfusion testing, an anti-Jka or -Jkb may go undetected.
It is therefore common to select c-negative and E-negative blood for transfusion patients who have an anti-E and lack the c antigen (in general, a patient will not produce antibodies against their own antigens). Anti-c is a common cause of delayed hemolytic transfusion reactions. [15]
Adverse effects reported with the usage of cryoprecipitate include hemolytic transfusion reactions, febrile non-hemolytic reactions, allergic reactions (ranging from urticaria to anaphylaxis), septic reactions, transfusion related acute lung injury, circulatory overload, transfusion-associated graft-versus-host disease, and post-transfusion purpura.
"Transfusion associated graft versus host disease" (PDF). Indian Pediatrics. 41 (12): 1260– 1264. PMID 15623910. Triulzi DJ (September 1992). "Transfusion associated graft vs. host disease and irradiated blood components". Archived from the original on 2006-07-22. Kardon E (8 July 2022). "Transfusion Reactions". EMedicine