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PA21.1-6 | Welcome to Transfusion Reactions & Investigation

Learning Objectives

  • Classify transfusion reactions as acute (<24 h) vs delayed and immune vs non-immune.
  • Describe the pathophysiology, clinical features, and consequences of acute haemolytic transfusion reaction (AHTR).
  • Explain febrile non-haemolytic, allergic, anaphylactic, and TRALI reactions.
  • Distinguish acute non-immune reactions: TACO, septic, and metabolic.
  • Identify delayed reactions: delayed haemolytic, TA-GVHD, iron overload, and post-transfusion purpura.
  • Enumerate the stepwise investigation of a suspected transfusion reaction in correct order.
  • Appreciate preventability — especially of ABO AHTR through bedside clerical checks.

INSTRUCTIONS

Every unit of blood is a biological transplant — and like any transplant, it carries the risk of rejection and adverse reactions. Transfusion reactions span from the trivial (mild urticaria) to the catastrophic (ABO haemolysis with DIC). As a clinician you will both administer transfusions and be first to recognise when something goes wrong. This module equips you with a classification framework, the ability to explain key mechanisms, and a practised response algorithm — skills that directly protect your patients.

References

  • Robbins & Kumar, Basic Pathology, 11th ed., Ch 11 (Red Cell Disorders) (textbook)
  • Harsh Mohan, Textbook of Pathology, 8th ed., Ch 12 (textbook)
  • AABB Technical Manual, 20th ed. (textbook)

Version 2.0 | NMC CBUC 2024