Transfusion Reactions

Written by Rachel Nall
Medically Reviewed by George Krucik, MD

What Are Transfusion Reactions?

If you have experienced severe blood loss, a blood transfusion can help restore strength and health. However, it is important that the blood is accurately matched to your blood type. If the blood type is not a match, you can experience a transfusion reaction. These reactions are rare, but they can affect your kidneys and lungs.

What Is the Transfusion Process?

Your physician may recommend a blood transfusion if you have lost blood or are not producing enough blood. This can be due to illness, surgery, cancer, infection, burns, injury, or other medical conditions.

Blood transfusions are most commonly done for blood components, such as red blood cells, platelets, or plasma. Before beginning a blood transfusion, a medical provider will draw your blood. This sample will be sent to a laboratory for typing and cross-matching. Typing is when the lab determines blood type. Cross-matching means to determine if your blood is compatible with a donor’s blood of the same type.

A number of blood types exist, including:

  • A positive
  • A negative
  • O positive
  • O negative
  • B positive
  • B negative
  • AB positive
  • AB negative

Knowing your blood type is important because red blood cells contain antigens or protein markers corresponding to these blood types. If a laboratory gives you the wrong type of blood, your immune system will detect any foreign proteins on the red blood cells of the wrong blood type and attempt to destroy them.

Blood banks have thorough testing processes to make sure blood is safe and typed for use. A doctor and/or nurse will explain any risks of blood transfusions to you and closely monitor you while you are receiving the blood.

Potential Symptoms of a Transfusion Reaction

Most blood transfusion reactions occur while you are receiving blood or immediately after. A medical provider will stay with you while you receive the transfusion. The provider will check your vital signs and watch for symptoms that you may be having a reaction.

Transfusion reaction symptoms include:

  • back pain
  • blood in your urine
  • chills
  • fainting or dizziness
  • fever
  • flank pain
  • skin flushing

In some instances, however, transfusion reactions take place days after the transfusion. Pay close attention to your body after a transfusion, and contact a doctor if you feel something isn’t right.

What Causes the Transfusion Reaction?

Antibodies in the recipient’s blood can attack the donor blood if the two are not compatible. If the recipient’s immune system attacks the red blood cells of the donor, it is called a hemolytic reaction. If the recipient’s immune system attacks the white blood cells of the donor blood, it is called a febrile reaction.

You can have an allergic reaction to a blood transfusion as well. These symptoms can include hives and itching. This reaction type is often treated with antihistamines.

Another transfusion reaction type is the transfusion related acute lung injury (TRALI). This reaction occurs when donor plasma contains antibodies that cause damage to the cells of the lungs. This lung damage results in fluid accumulating in the lungs and can severely limit the ability of the lungs to supply oxygen to the body. This reaction usually occurs within six hours of receiving blood.

In rare instances, bacteria may be present in the donated blood. Giving this contaminated blood to a recipient can lead to infection, shock, and death.

Also, transfusion reactions can occur because a person receives too much blood. This is known as circulatory overload. Having too much blood can overload your heart, forcing it to work harder to pump blood through your body.

You also can experience iron overload due to too much iron from donor blood. This can damage your heart and liver.

Possible Complications of a Transfusion Reaction

Transfusion reactions are not always serious. However, some can be life-threatening. Serious complications include

  • acute kidney failure
  • anemia
  • lung problems (pulmonary edema)
  • shock—a life-threatening condition that results from lack of adequate blood flow

Lowering Your Risk for a Transfusion Reaction

Blood banks make every effort to screen and test blood. A sample of recipient blood is often mixed with potential donor blood to ensure compatibility.

Before the blood is given to you, the blood label and your identity will be thoroughly checked. This ensures the nurse is giving the proper blood products to the right recipient.

How Is a Transfusion Reaction Treated?

If you or your medical provider observes blood transfusion reaction symptoms, the transfusion should be immediately stopped. A laboratory representative should come and draw blood from you and take the donated blood for testing to ensure they were matched appropriately.

Transfusion reactions can vary in severity. Some symptoms can be mild and treated with acetaminophen to reduce any pain or fever.

Your physician may also prescribe intravenous fluids or medications to reduce the likelihood of kidney failure and shock.

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