1. Blood and Blood Product Transfusion Reaction

2. History of blood group
In 1900, the German pathologist, Karl Landsteiner, identified 2 of antigenic proteins, which he called A and B
In 1940, Dr. Landsteiner discovered another group of antigens. They were named Rhesus factors (Rh factors) because they were discovered during experiments on Rhesus monkeys
The surface of red blood cells contain several proteins that can be identified by the body as antigens

3. Definition & Path physiology
Transfusion reaction is a complication of blood transfusion where there is an immune response against the transfused blood cells or other components of the transfusion

4. ABO & Rh compatibility
Blood is classified according to the presence of these antigens:
Group A contains antigen A
Group B contains antigen B
Group AB contains both antigens
Group O contains neither antigen
Blood plasma contains antibodies against the opposite antigen:
A person with Type A blood has antibodies against the B antigen
A person with Type B blood has antibodies against the A antigen
A person with Type AB blood has no antibodies (Universal Recipient)
A person with Type O blood has antibodies against the A,B&AB antigens (Universal Donor)

5. ABO & Rh compatibility
People with Rhesus factors in their blood are classified as "Rh positive"
People without the factors are classified as "Rh negative"
Rh negative persons form antibodies against the Rh factor if they are exposed to Rh positive blood
Conclusion:
Blood transfusion between incompatible groups causes an immune response against the cells carrying the antigen, resulting in transfusion reaction

6. Path physiology Immune system release antibodies Attach to a specific
antigen and
Cause its
destruction
Antigens enter the body
Transfusion reaction
occurred

7. Symptoms Fever Chills Rash Flank pain or back pain Bloody urine
Fainting or dizziness
Symptoms of transfusion reaction usually appear:
during transfusion
immediately after the transfusion
may develop after several days (delayed reaction)

8. Complications Discomfort Anemia Acute kidney failure Shock
Lung dysfunction

9. IMMEDIATE INTERVENTION
If symptoms occur during the transfusion:
Stop the infusion
Give reaction medications if ordered
Inform the doctor
Order Transfusion Reaction Workup with the components:
Transfusion reaction
Direct coombs
Urine analysis
Send blood bag, tubing and the collected specimens to the blood bank
Fill blood transfusion reaction form
Documentation

10. Medical Treatment
Antihistamines such as diphenhydramine to reduce itching and rash
Acetaminophen recommended to reduce fever and discomfort
Corticosteroids such as prednisone or dexamethasone to reduce the immune response
Intravenous fluids and various medications used to treat/prevent kidney failure and shock

11. Prevention
Typing of donated blood into ABO and Rh groups has reduced the risk of transfusion reaction:
Prior to a transfusion, blood is usually crossmatched to further confirm that the blood is compatible
A small amount of donor blood is mixed with a small amount of recipient blood and the mixture is examined under a microscope for signs of antibody reaction
Give Rhogam which is a sterile solution containing IgG anti-D(RH1) for use in preventing Rh immunization