Febrile non-hemolytic transfusion reaction

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Febrile non-hemolytic transfusion reaction
Other namesFebrile-type reaction
SpecialtyHematology

Febrile non-hemolytic transfusion reaction (FNHTR) is the most common type of

transfusion-associated acute lung injury, in which the donor plasma has antibodies directed against the recipient HLA antigens, mediating the characteristic lung damage.[citation needed
]

Definition

Symptoms must manifest within 4 hours of cessation of the transfusion, and should not be due to another cause such as an underlying infection, bacterial contamination of the blood component, or another type of transfusion reaction, e.g. acute hemolytic transfusion reaction.[7]

Fever must be at least 38 °C/100.4 °F oral and a change of at least 1 °C/1.8 °F from pre-transfusion value OR chills and/or rigors must be present.[7][8]

The UK hemovigilance system (SHOT) categorizes the severity of the reaction.[9]

Mild

Fever of at least 38 °C/100.4 °F oral and a change of between 1 and 2 °C from pre-transfusion values but no other symptoms or signs.[9]

Moderate

Fever of at least 39 °C, OR a rise in temperature of at least 2 °C from pre-transfusion values AND/OR other symptoms or signs, including chills (rigors), painful muscles (myalgia), or nausea that are severe enough that the transfusion is stopped.[9]

Severe

Fever of at least 39 °C, OR a rise in temperature of at least 2 °C from pre-transfusion values AND/OR other symptoms or signs, including chills (rigors), painful muscles (myalgia), or nausea that are severe enough that the transfusion is stopped AND requires immediate medical treatment, admission to hospital, or lengthens the duration of hospital admission.[9]

Treatment

Paracetamol has been used in treatment, and leukoreduction of future transfusions is sometimes performed.[10]

References

  1. PMID 10546797
    .
  2. PMID 20376259
    .
  3. S2CID 7005197
    .
  4. S2CID 20755367
    .
  5. ISBN 978-1-26-046205-0
    .
  6. ISBN 978-0-323-35317-5
    .
  7. ^ a b "Proposed standard definitions for surveillance of noninfectious adverse transfusion reactions" (PDF). www.isbtweb.org. Archived from the original (PDF) on 2020-11-28. Retrieved 2019-01-09.
  8. ^ "NHSN | CDC". www.cdc.gov. 2017-12-29. Retrieved 2018-09-18.
  9. ^ a b c d Bolton-Maggs, PHB; Poles, D (2018). "The 2017 Annual SHOT Report" (PDF). SHOT.
  10. ^ "Complications of Transfusion: Transfusion Medicine: Merck Manual Professional". Retrieved 2009-02-09.

External links

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