Blood transfusions remain an important and potentially life-saving form of treatment for people suffering traumatic or chronic blood loss. Despite stringent protocols to ensure the safety of people receiving a blood transfusion, complications uncommonly develop. Most blood transfusion complications are manageable and do not pose a long-term threat to health. Rarely, a potentially life-threatening complication may occur. Health-care professionals working in transfusion medicine closely monitor blood recipients to watch for signs of complications to ensure a rapid response.
Allergic Transfusion Reaction
A blood recipient may have an allergic reaction to a substance in the donor blood, which may occur during or after a transfusion. "The Merck Manual for Healthcare Professionals" reports that most allergic transfusion reactions are mild, causing symptoms such as hives, flushing, itching, headache, fever and dizziness. More severe allergic reactions may occur with wheezing and shortness of breath, which may progress to a full-blown anaphylactic reaction with rapid loss of blood pressure, high heart rate and heart rhythm abnormalities. Although rare, an anaphylactic transfusion reaction can be life threatening.
Acute Hemolytic Transfusion Reaction
An acute hemolytic transfusion reaction is a serious potential complication of a blood transfusion. This reaction occurs when the donor blood type is incompatible with the recipient's blood type. Preexisting antibodies in the recipient's bloodstream attack the donor's red blood cells, causing them to burst. The contents of the ruptured blood cells are toxic to the kidneys and may cause acute kidney failure.
The University of Michigan Health System Department of Pathology reports that signs and symptoms of an acute hemolytic transfusion reaction include heat and pain along the blood vessel into which the transfusion is flowing, low back pain, fever, chills, chest tightness, high heart rate, low blood pressure and an overwhelming sense of anxiety or dread. The blood transfusion is stopped immediately if there is any suspicion of this reaction.
Hyperkalemia
Hyperkalemia, or an abnormally high blood potassium level, is a potential complication of blood transfusion. Red blood cells contain a high concentration of potassium. Stored donor red blood cells leak some of this potassium into the fluid component of the blood, which enters the recipient's bloodstream upon transfusion.
In a 2008 review article on complications of blood transfusions published in the "Archives of Pathology and Laboratory Medicine," Drs. Anne Eder and Linda Chambers report that large volume, rapid transfusion of blood may rarely cause fatal hyperkalemia, with infants and children most vulnerable to this complication. The authors note that patients with kidney failure, functional liver impairment, or severe heart disease are at greatest risk for serious transfusion-related hyperkalemia.
References
- Merck Manual for Healthcare Professionals: Complications of Transfusion
- Trauma.org: Transfusion for Massive Blood Loss
- University of Michigan Health System Department of Pathology: 7 Adverse Reactions to Transfusion
- National Heart, Lung and Blood Institute: What Are the Risks of a Blood Transfusion?
- "Archives of Pathology and Laboratory Medicine"; Noninfectious Complications of Blood Transfusion; Anne F. Eder, M.D., Ph.D., Linda A. Chambers, M.D.; May 2007
