Skip to Content

Blood Transfusion Reactions


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 are the signs and symptoms of an immediate blood transfusion reaction?

Caregivers will stop the transfusion if you have any of the following immediate transfusion reactions:

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

What are the signs and symptoms of a delayed blood transfusion reaction?

A delayed blood transfusion reaction can begin 3 to 10 days after a transfusion. Other delayed reactions may cause a reaction the next time you receive blood. You may have any of the following:

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

How is a blood transfusion reaction diagnosed?

  • Blood tests: Your blood is tested for signs of destroyed red blood cells.
  • Urine tests: Your urine is tested for blood and for signs of kidney failure.
  • ECG test: Sticky pads are placed on your skin to record your heart's electrical activity if you have chest pain.

How is a blood transfusion reaction treated?

  • Medicines:
    • Antipyretic: This medicine reduces fever.
    • Antihistamines: Antihistamines decrease itching and swelling from a mild allergic reaction.
    • Epinephrine: Epinephrine is an emergency medicine given when antihistamines do not stop an allergic reaction.
    • Steroids: Steroids reduce inflammation and open your air passages so you can breathe more easily.
    • Bronchodilators: Bronchodilators relax muscles around your airway that tighten during an allergic reaction.
    • Vasopressors: This medicine increases your blood pressure to prevent shock caused by low blood pressure.
  • IV: Fluids are given by 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.

What increases my risk of a blood transfusion reaction?

The following are the most common risk factors for a blood transfusion reaction:

  • Past transfusion: Your risk increases if you have had a blood transfusion before. Your immune system forms antibodies that will attack donor blood the next time you get a transfusion.
  • Pregnancy: Your risk is also higher if you have been pregnant. You are exposed to fetal blood during pregnancy, which may make you more sensitive to donor blood.
  • Medical conditions: Certain medical conditions, such as sickle cell anemia, increase your risk. Sickle cell anemia causes the body to create antibodies that attack red blood cells. This form of anemia also requires frequent transfusions, which increases the risk as well.

How can I help prevent another blood transfusion reaction?

  • Give complete health information: Tell your caregivers about your health conditions, transfusions, and pregnancies.
  • Alert your caregivers: Tell your caregivers 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: Sometimes you can supply your own blood for transfusion during surgery. This is called autologous blood donation. Your blood will need to be drawn and stored a few weeks before a scheduled procedure.
  • Carry medical alert identification: Wear medical alert jewelry or carry a card that says you had a blood transfusion reaction. Caregivers may give you antipyretic or antihistamine medicine before the transfusion if you have had an allergic reaction.

When should I contact my caregiver?

Contact your caregiver if:

  • You have questions or concerns about blood transfusions.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have chest pain or feel short of breath.
  • You have a seizure.
  • You develop headaches or double vision.
  • 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. You feel lightheaded and confused. Your lips or fingernails look blue.
  • Your skin or the whites of your eyes look yellow.

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 caregivers 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.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.