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The page below is a sample from the LabCE course Transfusion Reactions. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Table: Additional Testing That May Be Ordered for Acute (Immediate) Transfusion Reaction Investigations

The table below lists the reaction types that were previously described and summarizes additional testing that may be ordered.

Acute Reaction Type
Additional Testing
Anaphylactoid and anaphylactic
  • Anti-IgA
  • IgA quantitative
Febrile nonhemolytic 
  • If initial testing is negative, perform a culture to rule out a bacterially-contaminated blood component
  • When other sources of the fever have been ruled out, the reaction is categorized as a febrile nonhemolytic transfusion reaction (FNHTR).
  • Bilirubin
  • Haptoglobin
  • Lactate dehydrogenase (LDH)
Transfusion-associated bacterial sepsis
  • Gram stain
  • Culture of component
  • Blood culture of recipient
Transfusion-associated circulatory overload (TACO)
  • Chest x-ray
  • B-type natriuretic peptide (BNP)
Transfusion-related acute lung injury (TRALI)
  • Chest x-ray
  • BNP
  • Leukocyte antibody screens (donor and recipient plasma)
  • Antigen typing of recipient