Blood transfusion complications Infectious & non infectious Dr.Khanaliha _2017

the noninfectious hazards or risks have gained attention NONINFECTIOUS RISKS OF BLOOD TRANSFUSIONS In fact, the noninfectious hazards or risks have gained attention partly because of the decrease in risk for infectious complications such as hepatitis and human immunodeficiency virus (HIV) infection.

Transfusion-associated circulatory overload (TACO): excessive administration of blood. Patients with cardiopulmonary disease, renal failure, and extremes of age (i.e., especially infants; see also Chapter 93) are especially vulnerable. decreasing the rate of infusion, administration of diuretics may be helpful.

Transfusion-related immunomodulation (TRIM): suppress the immune system because of circulating lymphocytes. transplant outcomes the effects on malignancy and infection are not clear

Chimerism refers to more than one cell line in an individual organism. Microchimerism: Chimerism refers to more than one cell line in an individual organism. . Specifically, donor lymphocytes may persist in a patient. pregnancy, transplant, and trauma. The outcome of patients with microchimerism is not known.

Posttransfusion purpura: recipient alloantibodies attacking donor platelet antigens treated with intravenous immunoglobulin.

Hypotensive transfusion reactions: Activation of the coagulation pathway activates production of bradykinin and allergic reactions.

Transfusion-associated graft-versus-host disease (GVHD): this refers to transfusion into an immunocompromised host. extremely serious and often fatal problem

Other complications Iron overload: Transfusion-related AKI. trOoOther Transfusion-related AKI. Undertransfusion and overtransfusion: Alloimmunization ) in 2-8% chronically recipient) Iron overload: HLA alloimmunization and human platelet antigen (HPA) alloimmunization:

“avoidance of unnecessary transfusions will be the most effective way to reduce complications of blood transfusions.”

TRANSFUSION-TRANSMITTED INFECTION The use of more sensitive screening tests and changes in transfusion medicine practices has made these infectious risks quite rare. demand for autologous blood has decreased The changes in blood transfusion testing

HEPATITIS Ninety percent of posttransfusion hepatitis is Fatigue (67%) • Hepatomegaly (67%) • Chronic hepatitis (23%) • Chronic active hepatitis (51%) • Hepatocellular carcinoma (11%) It was found that 20 patients had died of the following: • Complications of cirrhosis (8 patients) • Hepatocellular carcinoma (11 patients) • Chronic active hepatitis-pneumonia (1 patient) Ninety percent of posttransfusion hepatitis is caused by the hepatitis C donors from large cities have a more frequent incidence of the hepatitis virus).

CYTOMEGALOVIRUS the primary concern is recipients who are at risk because of pregnancy (multiple), immaturity, or immunosuppression. Asymptomatic chronic infection infectious mononucleosis–like syndrome that can occur 1 to 2 months after open-heart surgery is known as the postperfusion syndrome or posttransfusion mononucleosis. The risk for seroconversion is approximately 0.14% overall, Plasma components, such as FFP and cryoprecipitate, components from seronegative donors,

OTHER TRANSFUSION-ASSOCIATED INFECTIOUS DISEASES Y. enterocolitica is a bacterium that can cause mostly mild gastrointestinal problems. Posttransfusion syphilis with blood product that stored in room tempratures Malaria blood banksdonors for history of travel or migrationfrom areas where malaria is endemic. Creutzfeldt-Jakob disease