Untoward Transfusion Reaction Report: Fill & Download for Free

There are several ways of answering this question. First we could think about the immunological effects, second the clinical effects, third the social and personal financial effects, fourth the organisational effects and finally the medico-legal effects. Quite a lot of ground to cover and not something I propose to do in any detail.I am going to assume that you are mainly interested in the immunological and clinical effects. These are very closely linked as the type of immune response will amongst other factors such as the recipient’s general health, determine the clinical effects.If the recipient has pre-existing antibodies to the incompatible blood group(s) antigens contained in the transfused blood then an immediate reaction may occur within 15 minutes of starting the transfusion with fever, circulatory collapse and red cell destruction leading to jaundice, anaemia and possibly renal failure. The severity depends partly on how much incompatible blood has been transfused before the reaction is spotted by the vigilant nursing staff. For this reason great emphasis is placed on the importance of patient observations in the first 15–30 mins of transfusion of each unit of blood. An example of this scenario is transfusion of Group A blood to a Group O recipient. A Group O individual nearly always has natural, pre-existing potent anti-A (and anti-B) antibodies which can trigger a severe immunological reaction.If the recipient does not have pre-existing antibodies to the incompatible blood group(s) antigens contained in the transfused blood then there will either be no effect or delayed development of antibodies with little apparent reaction at the time. However re-exposure to the same antigens at a later stage may lead to a rise in the production of the relevant antibody over a few days leading to a reaction with fever and red cell destruction but not usually as sever as described for ABO incompatibility. An example of this scenario is transfusion of Rhesus D positive blood to a Rhesus D negative recipient. This second exposure would normally be prevented by the routine pre-transfusion blood grouping and screening of the recipient’s serum to see if any “irregular” antibodies were present.In the UK an ABO incompatible blood transfusion is considered a “never’ event i.e. one that should never occur. It would automatically trigger a serious untoward incident enquiry to establish the root causes and be reported to the national blood transfusion safety organisation called SHOT. These very rare incidents are a very important opportunity to learn from mistakes and improve practice.