What is the prognosis of transfusion reactions?

Updated: Jan 12, 2021
  • Author: S Gerald Sandler, MD, FCAP, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Acute hemolytic reactions (antibody mediated): Most severe and fatal reactions result from inadvertent transfusion of group AB or group A red cells to a group O recipient.

Acute hemolytic reactions (non–antibody mediated) are typically benign.

Nonhemolytic febrile reactions are discomforting but typically benign.

Allergic reactions are benign but bothersome to recipients.

Anaphylactic reactions are potentially, but rarely, fatal.

TRALI: In one study, 78% of patients with TRALI required initiation of mechanical ventilation, 25% required initiation of vasopressors, and 17% died; however, the researcher concluded that underlying risk factors for acute lung injury may have had the principal influence on clinical outcomes. [33] Early and intensive pulmonary support reduces the risk of a fatal outcome.

Circulatory (volume) overload: The outcome varies with the overall clinical status of the patient.

Bacterial contamination/endotoxemia is potentially fatal and may be caused by gram-positive or gram-negative bacteria. Early diagnosis, initiation of broad-spectrum antibiotics, and other intensive supportive measures may reverse the outcome of an otherwise fatal complication of transfusion.

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