Management of Allergic Reactions in Transfusion Medicine

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Questions and Answers

What is the main cause of TRALI (transfusion-related acute lung injury)?

Antibodies in previously alloimmunized recipients reacting with granulocytes in the donor unit (correct)
Infusion of response modifiers like cytokines in platelet concentrate
Interaction between leukocyte specific antigens on transfused leukocytes and antibodies in recipients
Reaction between platelets in the donor unit and cytokines in the recipient's blood

Why is it not routine to identify antibodies causing febrile non-hemolytic transfusion reactions?

Difficulty in demonstrating their presence in vitro (correct)
Presence of hemolysis makes antibody identification challenging
These antibodies are not present in vitro
Antibodies are only present post-transfusion

Which population is most susceptible to experiencing acute hemolytic transfusion reactions?

Children under the age of 5
Multiparous women and multiple transfused patients (correct)
Adult males who have never received a transfusion
Individuals with O- blood type

What is the recommended treatment for managing Febrile Non-Hemolytic Transfusion Reactions?

Administration of antipyretics (C) Signup and view all the answers

Why is acetaminophen preferred over aspirin for treating Febrile Non-Hemolytic Transfusion Reactions?

Acetaminophen does not affect platelet function (B) Signup and view all the answers

What is believed to cause urticarial reactions in Allergic Transfusion Reactions?

Interaction between donor antibodies and recipient plasma proteins (B) Signup and view all the answers

What is the primary purpose of the tests outlined in the text?

To evaluate potential transfusion reactions and identify their causes (A) Signup and view all the answers

Which of the following is NOT listed as a major cause of transfusion-associated fatalities?

Febrile non-hemolytic reaction (B) Signup and view all the answers

Which reaction is characterized by respiratory issues like wheezing, coughing, dyspnea, and cyanosis?

Both TRALI and TACO (A) Signup and view all the answers

Which of the following is NOT listed as a non-infectious transfusion reaction?

Sepsis (A) Signup and view all the answers

Which of the following reactions involve hemolysis?

Acute hemolytic transfusion reaction and delayed hemolytic transfusion reaction (A) Signup and view all the answers

Which of the following statements about reporting transfusion reactions is TRUE?

All transfusion reactions, regardless of severity, must be reported (B) Signup and view all the answers

Which of the following is NOT a common symptom of an anaphylactic transfusion reaction?

Fever (B) Signup and view all the answers

What is the recommended management for a patient experiencing Transfusion Related Acute Lung Injury (TRALI)?

Discontinue the transfusion immediately and provide respiratory support (C) Signup and view all the answers

Which of the following is a potential cause of Transfusion Related Acute Lung Injury (TRALI)?

Antibodies to HLA antigens (A) Signup and view all the answers

What is the recommended prevention strategy for Transfusion Related Acute Lung Injury (TRALI)?

Avoid using donors implicated in a previous TRALI reaction for plasma-containing components (D) Signup and view all the answers

Which of the following is a potential cause of bacterial contamination in a blood component?

Improper donor arm cleansing (A) Signup and view all the answers

What is the recommended management for a patient experiencing a bacterial contamination reaction?

Treat with broad-spectrum antibiotics and collect blood cultures (C) Signup and view all the answers

Which of the following is a potential complication of non-immune hemolysis during a transfusion?

Renal failure (C) Signup and view all the answers

What is the recommended preventive measure for patients experiencing recurrent urticarial reactions during transfusions?

Pre-treat with antihistamines prior to transfusion (D) Signup and view all the answers

Which of the following is a recommended step when investigating a suspected bacterial contamination reaction?

Visually inspect the blood unit for clots, discoloration, cloudiness, or hemolysis (C) Signup and view all the answers

Which of the following is a potential cause of cardiac arrhythmia during a non-immune hemolysis reaction?

Hyperkalemia (A) Signup and view all the answers

Study Notes

Management of allergic reactions during transfusion includes stopping the transfusion for mild urticarial reactions, maintaining IV access, and administering antihistamines orally or intramuscularly.
More severe allergic reactions require discontinuing the transfusion and providing aggressive treatment such as epinephrine, oxygen, and intubation.
Patients with recurrent urticarial reactions can be pre-treated with antihistamines before transfusion.
Anaphylactic transfusion reaction is the most severe form of allergic reaction, characterized by rapid and life-threatening symptoms like skin flushing, hypotension, shock, and cardiac arrest.
Management of anaphylactic transfusion reactions involves discontinuing the transfusion, maintaining IV access, treating hypotension, and administering epinephrine.
IgA deficient donors may contribute to anaphylactic transfusion reactions, and products from IgA deficient donors are recommended for prevention in susceptible patients.
Transfusion-related acute lung injury (TRALI) is characterized by acute respiratory insufficiency post-transfusion, often accompanied by chills, fever, and hypotension.
Management of TRALI includes immediate discontinuation of the transfusion and providing respiratory support to the patient.

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Description

Learn about the management of allergic reactions in the context of blood transfusions. This includes steps to take for mild urticarial reactions and more severe cases, as well as the appropriate use of antihistamines.