Causes Of Blood Transfusion Reactions: Symptoms And Treatment

Blood transfusion has become life saving when there is severe blood loss or if your body is not preparing enough blood and its components. While blood transfusion is of great benefit, it has its own risks. Transfusion reaction can occur if the donor’s blood type and recipient’s blood do not match. Although not common, transfusion reaction can sometimes lead to severe health consequences.

Procedure For Blood Transfusion

There are several medical reasons for transfusion of blood. Transfusion is advised by the physician when it is needed the most. It may be necessary if there is severe loss of blood from the body or if the blood and its components are not produced enough.

Blood loss usually occurs after an injury or an accident or during the surgical procedure. Production of blood may be affected in illness, infection or diseases such as cancer. Blood transfusion is done mainly to replenish the lost blood volume or deficiency of its components such as hemoglobin, plasma or platelets.

Blood grouping and cross matching is the first step before blood transfusion. The medical attendant will draw few milliliters (ml) of blood and send it to a pathology laboratory for determining the blood group and cross matching. In the laboratory blood group is ascertained.

It can be A positive, A negative, B positive, B negative, AB positive, AB negative, O positive or O negative. The blood of recipient and donor is also cross matched to see if it is compatible.

As from above you know there are different blood types. The red blood cells of each blood type have specific antigen or a marker. It should match with the same blood type of the donor that has to be transfused. If wrong blood group is transfused, the immune system of the recipient’s body will assume it to be a foreign protein and try to destroy it. This may lead to various symptoms of blood transfusion reaction.

Symptoms Of Blood Transfusion Reaction

The symptoms of blood transfusion reaction usually develop after few ml of incompatible blood is transfused in the recipient patient. Hence the medical attendant keeps a close monitoring of the vital signs while the blood is being transfused. In some cases the symptoms of transfusion reaction may develop after few days of transfusion. The signs and symptoms of transfusion reaction may be as follows:

  • Fever
  • Chills
  • Flushing of face
  • Severe pain at the infusion site
  • Nausea and vomiting
  • Pain in flank area, abdomen and in the chest
  • Severe body ache
  • Breathlessness
  • Low blood pressure
  • Rapid heart rate
  • Blood in urine
  • Dizziness
  • Hives and itching

What Causes Blood Transfusion Reactions?

If the blood group of donor is not compatible with that of recipient patient’s blood group type, the antibodies of recipient’s blood will attack the donor’s blood. The donor’s red blood cells are attacked. It is a hemolytic reaction.

When the white blood cells of the donor blood are attacked the condition is labeled as febrile reaction. Febrile reaction is the most common and frequent reaction associated with the transfusion of the blood components. It is a non hemolytic transfusion reaction. The reaction is characterized by fever and rigors.

A mild allergic reaction may occur during the blood transfusion. It is related to plasma proteins found in the transfused components. Usually the patient suffers from localized wheels and itching. In some cases fever and rigor may develop.

Transfusion related acute lung injury (TRALI) is uncommon reaction that occurs when the plasma antibodies of donor blood attacks the lung cells of the patient. Damage to the lungs causes accumulation of fluid in the lungs which compromises oxygen supply to body cells. The reaction occurs in 6 hours after the blood is transfused.

In some cases transfusion reaction can occur due to over load of blood volume. Too much of blood overload can make harder for the heart to pump blood.

Iron overload can occur if too much of iron is present in donor blood. Iron overload can affect liver and heart functions.

Rapid infusion of refrigerated blood components can lead to hypothermia.

Infections transmitted by blood transfusion are rare, but they can occur such as hepatitis, syphilis, malaria and AIDS.

Anaphylactic reaction although rare can occur after transfusion of only few ml of blood. The symptoms include difficulty in breathing, nausea and vomiting, low blood pressure, loss of consciousness, respiratory distress and shock. It is a serious reaction which needs to be treated immediately.

Usually all efforts are made by the blood bank and the doctors to test and screen the blood before it is transfused. A blood sample of donor and recipient is matched for compatibility. Only then it is transfused. Proper labeling and patients identity is checked before transfusion. This will ensure normal survival of the transfused blood and safety of the recipient.

How To Treat Blood Transfusion Reaction?

When the patient or the medical attendant observes symptoms of transfusion reaction, the first and immediate step is to stop blood transfusion. Mild transfusion reaction such as allergic hives, rigors, or mild fever is treated with antihistamine and fever medicines. However, if it is serious reaction, transfusion is stopped immediately and blood bank is informed.

A representative from the blood back will collect blood sample of recipient and take the donor blood for retesting whether both the blood are matched properly. In some transfusion reaction such as anaphylactic reaction treatment includes stopping of transfusion, administration of intravenous fluid, glucocorticoids and adrenaline.