Possible risks of blood transfusions

Although blood transfusions can be life-saving, they are not without risks. Infections were once the main risk, but they have become extremely rare with careful testing and donor screening. Transfusion reactions and other non-infectious problems are now more common.

When you are getting a transfusion of any kind, it’s very important that you let your nurse know right away if you notice any changes in how you feel, such as itching, shivering, headache, chest or back pain, throat tightness, nausea, dizziness, trouble breathing, or other problems. You should report any that happen in the next few days, too.

Transfusion reactions

Blood transfusions sometimes cause transfusion reactions. There are several types of reactions and some are worse than others. Some reactions happen as soon as the transfusion is started, while others take several days or even longer to develop.

Many precautions are taken before a transfusion is started to keep reactions from happening. The blood type of the unit is checked many times, and the unit is cross-matched to be sure that it matches the blood type of the person who will get it. After that, both a nurse and blood bank lab technician look at the information about the patient and the information on the unit of blood (or blood component) before it’s released. The information is double-checked once more in the patient’s presence before the transfusion is started.

Allergic reaction

This is the most common reaction. It happens during the transfusion when the body reacts to plasma proteins or other substances in the donated blood. Usually the only symptoms are hives and itching, which can be treated with antihistamines like diphenhydramine (Benadryl). In rare cases these reactions can be more serious.

Febrile reaction

The person gets a sudden fever during or within 24 hours of the transfusion. Headache, nausea, chills, or a general feeling of discomfort may come with the fever. Acetaminophen (Tylenol) may help these symptoms.

These reactions are often the body’s response to white blood cells in the donated blood. They are more common in people who have had transfusions before and in women who have been pregnant several times. Other types of reaction can also cause fever, and further testing may be needed to be sure that the reaction is only febrile.

Patients who have had febrile reactions or who are at risk for them are usually given blood products that are leukoreduced (loo-ko-re-DUCED). This means that the white blood cells have been removed by filters or other means.