Paper I
Question
Various adverse reactions of blood transfusion.
Answer
Immunologic (immune-mediated) reactions
- Acute haemolytic transfusion reaction (ABO incompatibility) — most serious, complement-mediated intravascular haemolysis
- Delayed haemolytic transfusion reaction (minor Rh/other antigen sensitization)
- Febrile non-haemolytic transfusion reaction (anti-leukocyte antibodies/cytokines in stored blood)
- Allergic/urticarial reactions (plasma protein hypersensitivity)
- Anaphylactic reaction (IgA-deficient recipients with anti-IgA antibodies)
- Transfusion-related acute lung injury (TRALI) — donor anti-leukocyte antibodies causing pulmonary oedema
- Graft-versus-host disease (immunocompromised recipients, non-irradiated blood)
- Post-transfusion purpura
Non-immunologic reactions
- Transfusion-associated circulatory overload (TACO)
- Transmission of infections (HIV, hepatitis B/C, CMV, bacterial contamination/sepsis)
- Iron overload (with repeated transfusions)
- Hypocalcaemia/citrate toxicity (massive transfusion)
- Hyperkalaemia (massive/rapid transfusion of stored blood)