Transfusion Reactions
HIV transmission is mostly a thing of the distant past, and we are far less worried about infections in general. Transfusion reactions, however, remain a big deal.
Modern-day transfusion has become much safer from infection than in decades past. Incredible advances in testing have rendered disease transmission after transfusion extremely uncommon. That fact, however, does NOT mean that transfusions are without risk! There is growing awareness of potential adverse effects of transfusion, including the possibilities of immunosuppression after transfusion and direct adverse effects from substances that accumulate in blood during storage. The current U.S. and worldwide emphasis on patient blood management is beginning to impact the way that transfusions are ordered (and not ordered!), with an eye toward improving patient safety. Despite this environment, transfusion reactions still occur with significant frequency, and they cause the vast majority of deaths reported to the FDA year after year.
Transfusion reactions can take many shapes, sizes, and forms. This section will deal with the essentials of how to recognize transfusion reactions, evaluate them at the bedside and in the laboratory, and treat and prevent them. We will deal first with the general principles of recognizing and evaluating possible reactions, then hone in on significant aspects of specific transfusion reactions. I recommend that you start with part 1 (recognizing and evaluating possible reactions), then proceed to the individual reactions, but you may certainly skip around using the navigation area at right as well.