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 Vol. 7 No. 2, February 2006
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NeoReviews Vol.7 No.2 2006 e69
© 2006 American Academy of Pediatrics

Hazards of Neonatal Blood Transfusion

Susan A. Galel, MD*
Magali J. Fontaine, MD, PhD{dagger}

* Associate Professor, Department of Pathology, Stanford University School of Medicine; Director of Clinical Operations, Stanford Blood Center, Palo Alto, Calif
{dagger} Assistant Professor, Department of Pathology, Stanford University School of Medicine; Associate Director, Transfusion Service, Stanford Hospital and Clinics, Stanford, Calif

The first 300 words of the full text of this article appear below.


   Objectives
 
After completing this article, readers should be able to:

  1. Describe acute immune-mediated transfusion reactions seen in neonates, their treatment, and their prevention.
  2. Describe acute nonimmune-mediated transfusion reactions seen in neonates, their treatment, and their prevention.
  3. Describe delayed transfusion complications.
  4. Delineate the steps involved in the blood donor screening process in the United States.


   Introduction
 
The safest blood transfusion is the one not administered. When a transfusion is needed, it is important for both physicians and nursing staff to be aware of its potential acute and delayed adverse effects. Adverse consequences may be minimized through early recognition and prompt therapeutic intervention.


   Noninfectious Complications of Transfusion
 
Noninfectious complications may be either acute (occurring within hours of transfusion) or delayed. Acute reactions may be categorized further according to their pathogenesis: immunologic versus nonimmunologic.

Patients should be monitored closely during the transfusion. For all suspected transfusion reactions, the ordering physician and the nursing staff should be trained to stop the transfusion immediately, keep the intravenous line open, check that the blood component was given to the correct patient, and assess and treat symptoms. A posttransfusion blood specimen and the blood bags should be sent to the Transfusion Service (TS) along with a transfusion reaction report form that includes patient diagnosis, history of previous reactions, date and time of reaction with associated symptoms, and vital signs before and after the transfusion. The TS technologist performs a clerical check, inspects posttransfusion blood samples for hemolysis, and repeats ABO/Rh testing on both the transfused unit and the patient’s sample along with a direct antiglobulin (Coombs) test. Further testing is guided by the nature of the patient’s symptoms. Suspected delayed complications of transfusion also should be reported to the TS so the appropriate investigation may be initiated.

     Acute Immune-mediated Transfusion Reactions
Acute hemolytic transfusion reactions are the second most common cause of transfusion-related fatality in adult patients, . . . [Full Text of this Article]






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Copyright © 2006 by the American Academy of Pediatrics.