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Categories of Transfusion Reactions

Adverse complications of transfusions can be classified into several categories:

  • Immune-mediated transfusion reactions are those that trigger a response from the patient's immune system. Many transfusion reactions are mediated by the recipient's immune system. These reactions occur as a result of antigen-antibody interactions. Antibodies involved include those with specificity towards antigens on red cells, white cells, or platelets. In general, the immune responses occur in three stages:
    • The immune system detects foreign material (antigen)
    • The immune system processes the antigen
    • The immune system mounts a response to remove the antigen from the body
  • Non-immune mediated hemolytic transfusion reactions are caused by the physical or chemical destruction of transfused RBCs, bacterial contamination, circulatory overload, or citrate toxicity.
  • Acute (immediate) reactions are those that occur during or within 24 hours after the transfusion. There is usually a rapid onset of symptoms and these reactions may be fatal.
  • Delayed reactions occur weeks or months after the transfusion of blood or blood components.