Blood transfusions are prescribed for many reasons, including blood loss and abnormal blood counts. Although hospitals and clinics follow strict protocols for safe transfusion, mistakes by staff and bad reactions from patients to the blood infusion complicate the transfusion process and, at times, result in harm to the patient. Knowing the possible complications arms the patient and family members with better knowledge before consenting to the blood transfusion.
Hemolytic Reactions
Remarkably, nearly 20 percent of the errors made with blood type incompatibility transpire at the hand of the physician in an operating room, according to Anesthesiology Info. Symptoms of a hemolytic, or red blood cell incompatibility reaction, include rapid heart beat, low blood pressure, shock, kidney failure and uncontrollable bleeding from the nose, mouth, ears, skin and incision, known as disseminated intravascular coagulation, or DIC.
A delayed reaction to a blood transfusion may also occur. After a normal blood transfusion that seems compatible, antibodies can form. When the body is again exposed to incompatible antigens, the immune system responds with fever, jaundice, decreased blood cell count and overall malaise. This type of reaction often occurs when a mother and baby have different blood types and the mother receives blood some months later in an event unrelated to pregnancy.
Non-Hemolytic Reactions
Reactions classified as non-hemolytic, or non-red blood cell reactions, include fever, hives, itching, anaphylactic shock and pulmonary edema. Anaphylactic reactions, although rare, can cause serious life-threatening complications and need immediate treatment with epinephrine. Pulmonary edema, especially serious in congestive heart failure patients, loads the tissues of the heart and lungs with fluid and causes respiratory distress. Immediate treatment with a systemic diuretic such as furosemide, or Lasix, alleviates the problem.
Infectious Disease Process
Hepatitis A, B and C carry the highest rates of infection from blood transfusions, according to Anesthesiology Info. The likelihood of receiving an AIDS-tainted blood transfusion in the United States is extremely rare, according to the NIH. Anesthesiology Info claims the ratio to be 1 in 200,000 to 2,000,000. Parasitic infections of malaria or toxoplasmosis may also occur, but again, in the United States these complications rarely materialize with blood transfusions due to low incidence of these diseases and strict blood screening.
Massive Transfusion Reactions
Complications specific to massive blood transfusion--when the patient receives more than one or two units of blood--may result in coagulation problems due to a low white blood cell count and hypothermia. The latter can be avoided if the blood is warmed to body temperature prior to the blood transfusion.
