What are the adverse reactions after blood transfusion?

Generally, adverse reactions that may occur after blood transfusion mainly include febrile reactions, allergic reactions, hemolytic reactions, circulatory overload, and transmission of infections. A detailed analysis is as follows:

1. Febrile reaction: This is the most common adverse reaction, typically occurring within 1–2 hours after transfusion. It manifests as a temperature rise above 38°C, accompanied by chills, headache, and fatigue. It is often associated with residual white blood cells or pyrogenic substances in blood products and symptoms are usually mild.

2. Allergic reaction: Symptoms include skin itching, erythema, and urticaria; severe cases may involve laryngeal edema and difficulty breathing. These reactions are mostly related to patient allergies to proteins or other components in blood products. Individuals with allergic predispositions have a relatively higher risk and require timely intervention.

3. Hemolytic reaction: This is a serious adverse reaction, classified into acute and chronic types. Acute hemolysis rapidly presents after transfusion with fever, back pain, abdominal pain, and hemoglobinuria. Chronic cases manifest as jaundice and worsening anemia, mostly caused by incompatible blood types or improper handling of blood products.

4. Circulatory overload: Commonly seen in elderly or frail patients and those with cardiac insufficiency, it presents as chest tightness, shortness of breath, respiratory distress, and coughing up pink frothy sputum. It results from rapid transfusion rates or excessive blood volume, increasing cardiac load and potentially leading to acute heart failure.

5. Transmission of infection: Although the incidence is extremely low, transfusion may still transmit diseases such as hepatitis, HIV, and syphilis. This usually occurs when donors are in the window period of infection or when blood product testing is incomplete. Standardized blood screening can reduce this risk.

The occurrence of adverse reactions after blood transfusion is related to multiple factors. Strict adherence to standardized transfusion procedures and enhanced monitoring during transfusion are essential to ensure the safety and effectiveness of blood transfusion.