An Overview of the Identification, Prevention, and Management of Immunological Reactions to Blood Transfusion

Abstract

lood transfusions are prevalent treatment procedures nowadays for various medical conditions that involve the administration of whole blood or separated blood components alone or in various combinations that can be administered intravenously; these are undertaken with therapeutic or curative goals in mind, they may carry associated risks and complications that must be weighed against the benefits before initiating therapy. A typical subset of complications associated with transfusions includes Transfusion reactions. These include Non-infectious (Acute and Delayed) and infectious complications. Non-infectious transfusion reactions include Immune-mediated reactions to blood components, such as Febrile Non-hemolytic Transfusion reactions (FNHTR), Allergic Transfusion reactions, Hemolytic Transfusion reactions (HTR), Transfusion-related Acute Lung Injury (TRALI), and Transfusion Associated Graft versus Host Disease (TAGVHD), these reactions have different mechanism and complications between them. They can be differentiated for the mechanism of action, presentation time, and clinic. Blood transfusion immunological reactions remain a significant concern in clinical settings, leading to various symptoms. Diagnosing these reactions requires careful monitoring and evaluation of the patient’s clinical status and laboratory parameters. The prevention methods for these reactions include pre-transfusion testing, selecting appropriate blood products, and using leukoreduced blood products. Treatment options may include supportive care, discontinuation of transfusion, and immunosuppressive therapy in severe cases. This article aims to provide an overview of how to identify immune-mediated transfusion reactions, manage them as they occur, and even prevent them if possible.