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Immunologic blood transfusion reactions

INTRODUCTION

Untoward effects of blood transfusion are not unexpected and in many cases are benign. However, some reactions cause serious morbidity and may be fatal [1]. The problem is that the initial symptoms of reactions with serious or relatively benign consequences are often similar.

Adverse reactions can occur in any blood transfusion recipient, but are more common in patients with hematologic and oncologic diseases [2,3]. They can be categorized as immunologic, infectious, chemical, and physical; some also subdivide these reactions into acute and delayed types [4]. The "classic" transfusion reactions are immunologic in nature and result from the interaction(s) of inherited or acquired antibodies with foreign antigens associated with cellular or humoral components of transfused blood products.

The major immunologic reactions to blood transfusion will be discussed here:

  • Febrile nonhemolytic transfusion reactions
  • Acute hemolytic transfusion reactions
  • Delayed hemolytic transfusion reactions
  • Anaphylactic transfusion reactions
  • Urticarial transfusion reactions
  • Posttransfusion purpura

Transfusion-related acute lung injury (TRALI) is discussed separately. (See "Transfusion-related acute lung injury (pulmonary leukoagglutinin reactions)".)
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