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Blood Transfusion Reactions

Medically reviewed by Last updated on Aug 31, 2022.

What is a blood transfusion reaction?

A blood transfusion reaction is a harmful immune system response to donor blood. Reactions can occur right away or much later, and can be mild or severe.

What causes a blood transfusion reaction?

Your immune system can react to anything in the donor blood. One of the most serious reactions is called ABO incompatibility. The 4 main blood types are A, B, O, and AB. Your immune system will try to destroy donor cells that are the wrong type for you. Another reaction happens when you are allergic to something in the donor blood. Allergic reactions are usually mild but can become a life-threatening reaction called anaphylaxis.

What increases my risk for a blood transfusion reaction?

  • You had a blood transfusion before. Your immune system will attack donor blood the next time you get a transfusion.
  • You have been pregnant. You may be more sensitive to donor blood after you are exposed to a baby's blood during pregnancy.

What are the signs and symptoms of an immediate reaction?

Healthcare providers will stop the transfusion if you have any of the following:

  • A strong feeling of dread or that something is wrong
  • Fainting or breathing problems
  • Fever and chills
  • Itching, hives, or swelling
  • Pain or burning in your abdomen, chest, or back, or at the transfusion site
  • Swelling and a large bruise at the transfusion site
  • Blood in your urine
  • Nausea, vomiting, or diarrhea

What are the signs and symptoms of a delayed reaction?

A delayed blood transfusion reaction can begin within 3 to 10 days. You may also have a reaction the next time you receive blood.

  • A high fever and chills
  • Dizziness or fainting
  • Little or no urination
  • Headaches, double vision, or seizures
  • Yellowing of your skin or the whites of your eyes
  • Chest pain or shortness of breath
  • Bruises, fatigue, or weakness

How is a blood transfusion reaction diagnosed and treated?

Your blood and urine will be tested for signs of kidney failure or destroyed red blood cells. You may need any of the following to treat a reaction:

  • Medicines may be given to decrease itching and swelling from a mild reaction. Epinephrine is an emergency medicine given when antihistamines do not stop an allergic reaction. You may also need medicine to relax muscles in your throat and chest to help you breathe, or to raise your blood pressure. Medicine may also be given to lower a fever.
  • Fluids may be given through your IV to prevent your blood pressure from falling too low. IV fluids will also help your kidneys get rid of donor red blood cells that your immune system has destroyed.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

How can I help prevent another blood transfusion reaction?

  • Give complete health information. Tell your healthcare providers about your health conditions, transfusions, and pregnancies.
  • Alert your healthcare providers about any problems. Tell your healthcare providers right away if something feels wrong. They will stop the transfusion and treat your symptoms. Pain, nausea, itching, or a large bruise at the transfusion site are good reasons to stop the transfusion.
  • Ask if you can use your own blood. You may be able to get your own blood during surgery. Your blood will need to be drawn and stored a few weeks before a scheduled surgery.
  • Carry medical alert identification. Wear jewelry or carry a card that says you had a blood transfusion reaction. Healthcare providers may give you medicine before the transfusion to prevent a reaction.

Call 911 for any of the following:

  • You have a skin rash, hives, swelling, or itching.
  • You have trouble breathing, shortness of breath, wheezing, or coughing.
  • Your throat tightens or your lips or tongue swell.
  • You have difficulty swallowing or speaking.

When should I seek immediate care?

  • You have a seizure.
  • You have a headache or double vision.
  • You are lightheaded, confused, or feel like you are going to faint.
  • You have nausea, diarrhea, or abdominal cramps, or you are vomiting.
  • You see pinpoint purple spots or purple patches on your body.
  • You feel dizzy and weak about 7 days after your transfusion.
  • Your skin feels sweaty and cold.
  • Your lips or fingernails look blue.
  • Your skin or the whites of your eyes look yellow.

When should I contact my healthcare provider?

  • You have questions or concerns about blood transfusions.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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