tailieunhanh - Chapter 107. Transfusion Biology and Therapy (Part 7)

Anaphylactic Reaction This severe reaction presents after transfusion of only a few milliliters of the blood component. Symptoms and signs include difficulty breathing, coughing, nausea and vomiting, hypotension, bronchospasm, loss of consciousness, respiratory arrest, and shock. Treatment includes stopping the transfusion, maintaining vascular access, and administering epinephrine (– mL of 1:1000 dilution subcutaneously). Glucocorticoids may be required in severe cases. | Chapter 107. Transfusion Biology and Therapy Part 7 Anaphylactic Reaction This severe reaction presents after transfusion of only a few milliliters of the blood component. Symptoms and signs include difficulty breathing coughing nausea and vomiting hypotension bronchospasm loss of consciousness respiratory arrest and shock. Treatment includes stopping the transfusion maintaining vascular access and administering epinephrine mL of 1 1000 dilution subcutaneously . Glucocorticoids may be required in severe cases. Patients who are IgA-deficient 1 of the population may be sensitized to this Ig class and are at risk for anaphylactic reactions associated with plasma transfusion. Individuals with severe IgA deficiency should therefore receive only IgA-deficient plasma and washed cellular blood components. Patients who have anaphylactic or repeated allergic reactions to blood components should be tested for IgA deficiency. Graft-versus-Host Disease Graft-versus-host disease GVHD is a frequent complication of allogeneic stem cell transplantation in which lymphocytes from the donor attack and cannot be eliminated by an immunodeficient host. Transfusion-related GVHD is mediated by donor T lymphocytes that recognize host HLA antigens as foreign and mount an immune response which is manifested clinically by the development of fever a characteristic cutaneous eruption diarrhea and liver function abnormalities. GVHD can also occur when blood components that contain viable T lymphocytes are transfused to immunodeficient recipients or to immunocompetent recipients who share HLA antigens with the donor . a family donor . In addition to the aforementioned clinical features of GVHD transfusion-associated GVHD TA-GVHD is characterized by marrow aplasia and pancytopenia. TA-GVHD is highly resistant to treatment with immunosuppressive therapies including glucocorticoids cyclosporine antithymocyte globulin and ablative therapy followed by allogeneic bone marrow transplantation.