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Platelet Transfusion Blood Transfusion Management of Transfusion Reactions
Home | Articles | Blood Transfusion | Management of Transfusion Reactions

Management of Transfusion Reactions

Last updated 26th January 2022

Record all Suspected Transfusion Reactions in Medical Notes

  1. Reporting of clinical incidents, near miss or adverse events associated with transfusion via Datix. Reporting categories include:
    • Cell salvage
    • Anti D
    • Adverse events such as wrong blood transfused, special requirements not met, unnecessary or inappropriate transfusion, handling or storage errors,
    • Right blood to right patient where a patient was transfused correctly despite one or more serious errors which in other circumstances might have led to an incompatible blood component transfused. This includes labelling errors and administration with incorrect missing details.
    • Physiological reactions such as acute transfusion reaction (up to 24 hours post transfusion), this includes febrile reactions or febrile reaction with other signs and symptoms, minor allergic reactions or anaphylaxis, sever allergic reaction or evidence of hypotension of >30mm Hg occurring within one hour of the transfusion provided all other adverse reactions are excluded. Haemolytic transfusion reactions (acute or delayed), post transfusion purpura, transfusion associated graft vs host disease or any other previously uncategorised complication of transfusion
    • Pulmonary complications of transfusion which include transfusion associated circulatory overload, transfusion related acute lung injury, transfusion associated dyspnoea
    • Transfusion transmitted infection where the recipient has evidence of infection post transfusion and there is no evidence of infection prior to transfusion and no evidence of an alternative source of infection
  2. The reporting of near miss events include any errors or deviation form standard procedures or policies which is discovered before the start of the transfusion which could have led to a wrongful transfusion or to a reaction in a recipient.

If in Doubt Report Via Datix

  1. All incidents, near miss or adverse events reported will be investigated by the Transfusion Practitioner, and reviewed by the Hospital Transfusion team for reporting to the NHS Dumfries and Galloway Transfusion Committee.

Laboratory Samples

  1. ABO Incompatibility/Haemolytic reaction/Bacterial infection of unit/suspected Transfusion Related Acute Lung Injury (TRALI)
    • repeat transfusion sample (for X-match, group, DCT) + FBC + Coag sample + 2 x clotted sample (1 sample to Biochem for renal & liver function haptoglobins & LDH and 1 sample to Transfusion lab) + urine sample (haemoglobinuria, urobilinogen) + Blood cultures (if suspected bacterial contamination)
  2. Severe allergic reaction – Biochem clotted sample for IgA deficiency
  3. Record all transfusion reactions in notes and report all major transfusion reactions as clinical incidents

Management of Transfusion Reactions

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