Gross Description -- Transfusion Reaction

CASE RESOLUTION:

A clerical check revealed no irregularities and examination of the post transfusion samples showed no evidence of hemolysis. An acute hemolytic transfusion reaction was quickly ruled out. The patient was intubated, ventilated and diuresed. He responded to these interventions with resolution of his symptoms and extubation within 24 hours. Although the sudden onset of dyspnea raises the possibility of transfusion related acute lung injury, the presence of hypertension, jugular venous distension and response to diuretics is highly suggestive of volume overload as the cause of the transfusion reaction. Following a complete investigation, the case was signed out as volume overload.

OBJECTIVES:

1. Learn basic steps necessary to work up an adverse transfusion reaction.
2. Know the differential diagnoses to consider when dealing with a transfusion reaction.
3. Know the signs and symptoms that differentiate febrile non-hemolytic transfusion reactions from transfusion related acute lung injury and volume overload reactions.

DISCUSSION