Does jaundice normally increase post transfusion?

Hi Everybody,
My son had his first transfusion on Tuesday. Wednesday his eyes were more yellow than before and today they are even more than that. I s this normal after a transfusion?
Zahra

Zahra,

I am sorry i don't exactly remember what is the cause of paleness in eyes,post transfusion,i  remember reading somewhere that paleness in eyes is the indication of bilirubin which is bi product of hemolysis , i am sorry i am not very good with the technical stuff,please wait for Sharmin,Manal or Andy.

Zaini.

hi Zahra

Dont worry, yellowish eyes are linked with haemolysis and they are very common with thal kids. give it a day or two and keep a look out for any rash or fever.

Dear Zahra

Did you use filter when you did the transfusion???

The reason for the yellow color could be the excess hemolysis or break down of the transfused red cells. This happens because antibodies in the blood react to the antigens in the donor blood. To avoid this an accurate cross match has to be done and usage of a filter during transfusion is very important

In my country, they usually give cortisone injection right before  the transfusions. This can help control the immediate antibody reaction and lead to longer life of the red blood cells

Did you check Hb after transfusion?

manal

Zahra,

As the others have said,  yellow in the eyes is a sign of hemolysis.  I don't remember this reaction with my son after his first transfusion. 
If the yellow in his eyes is increasing that rapidly please see his doctor immediately as too much bilirubin is not good for him.  It is difficult for you to assess based on appearance, so you need to have a blood test for him.  I am sure that he will be fine, but if he has excessive jaundice then your doctor will need to intervene. 

Please keep us posted,

Sharmin

Hi,
I spent 6 hours in the emergency only to be told to come after the weekend. Today the doc said his Bilirubin is high at 73 ( normal is 34 he said) but is a part of being thalasemic and isnt anything to be concerned about. So now I go after 3 weeks . Are all thalasemics jaundiced? Even if transfused with healthy RBC's? The good news is his HB is 14.
Zahra

Congratulations Zahra on the Hb, i wish he can keep it as much as possible

manal

Zahra,

I am glad that there isn't anything to worry about.  The fact that his hg is so nice and high means that excessive hemolysis is not going on.  That is a great hg  
The amount of bilirubin and jaundice varies from one patient to another.  Some patients have elevated bilirubin levels and other don't.  I think things like jaundice vary from patient to patient, and even in individual patients I think that it varies over time.  When I heard that his eyes were yellow I wanted to make sure that he was not having hemolysis - I am glad that everything is fine. 

All the best to your little one,

Sharmin

Hi Manal,
Sorry for replying late. The blood was leucocyte reduced. I think that means the same as filtered but he didnt get any cortisone injection. They did give him paracetamol and an antiallergy medicine before transfusing.
On reading my previous post again I realise I havent been fair to the emergency . They did see my son and do his blood tests . Even told me the results . I just had to wait for my doctor after the weekend to give me the reassurance I needed that my child was ok.
Now after the transfusion my son has become very hungry . He's finally started on solid foods and is gaining weight again
I dont know how to thank you all enough for being here.
Zahra

Hi Manal

I hv never heard the use of cortisone before transfusions. Is it commonly used in Egypt. I am not sure why it is not being used in PGI(Prat's hospital), on regular transfusion dependent kids.

Is it new or has it been used for a while in egypt.

Thanks

Puja

Zahra

I am so happy for you and happy that you child feels well  As for the term ''leucocyte reduced'' i don't know it is the same meaning as filtered red packed cells or not cause the word reduced means just decreased. I am not sure wha really reduce indicate.

But when my son wassupposed to transfusedatthe beginning of his diagnosis ( actually we didn't transfuse), but it was written in the order for the blood bank '' washed filtered irradiated red packed blood cells''
Washed means ... no plasma
filtered means.......no white blood cells
irradiated means...... that it should be without acteria or viruses (if i am not mistaken, actually not sure)


Puja,

I will check if this injection is a general protocol or it was the way this hematologist way. But generally this injection is supposed to control the immediate antibody reaction, i will let you know

manal