Transfusion reactions other than TRALI

It happened to me again!

Today, during halfway through the transfusion I noticed red itchy blotches all over my body and this time I had no trouble breathing as before; which I previously thought(In Danielle's TRALI thread) that I was experiencing TRALI.

I called the staff nurse and he came back with that dreaded Avil Inj. . Amazingly today it didn't hurt a bit and I felt no side effects as previously stated in the TRALI thread. I also noticed that it wasn't working too as I didn't feel the itchy blotches getting better.

Near the end of the Transfusion I noticed some Plasma floating above the red cells and I thought to my self that I won't let that go in as it probably contained all that gunk(like Poirot said ) my body reacted to.

Meanwhile three medical students came and asked me for their research interview, I got distracted in that and forgot to stop the transx. before the plasma went in. Anyway I didn't feel anything unusual for sometime and when my attendant came to take me home; Avil kicked-in .

Thank God I was besides the bed and lied down as my vision started to blacken and my ears started buzzing. I could hardly hear my attendant asking me if anything was wrong. He got worried and called the nurse who just said "Don't worry, this is just the effects of Avil." He just ignored it while I wondered why did Avil kicked in late after about an hour or so? Was the high concentration of gunk in the floating plasma caused Avil's reaction? as there was no reaction till the red cells lasted in the bag.

Dear Sajid,

The red blotches ( hives) you get during transfusion is a manifestation of an allergic reaction, and it can be quite severe and pretty distressing. I do not think it is as harmful as an antibody reaction but according to my observation it is connected to plasma. Plasma in the blood bag can and may cause this reaction, I would say due to plasma proteins. I never had this reaction when I was taking washed blood in Bombay.

Even with packed red cells if plasma remains, there is this possibility of hives.  So plasma should be removed properly and of course I recommend washing.  Many blood banks which do not have expert technicians do not cater to washing of blood due to fear of contamination, which is why we may suffer the allergic reactions.

Also, I would like to tell you that once the blotches develop...an antihistamine like Avil will "only reduce/prevent further allergic reaction."   The hives or urticaria has to run its course once it manifests...Avil will not cure that..
 
I think maybe you can consult with your doctor about taking the Avil/antihistamine before the transfusion, if no other course of action seems available to you. 

Regards,
Shilpa.

Hello Shilpa,

It's not like this that I get the reaction every time! Like I said in my reply to Mr. Poirot that sometime there is plasma left over in the bag due to improper processing for making a packed red cells bag. Sometimes that plasma reacts and sometimes it doesn't.

Personally I don't like the idea of taking Avil before every transX. It's after effects are pretty uncomfortable and I think we should avoid unnecessary medication if there is no real need for it; besides,  I always take oral anti-histamine before the TransX, but sometimes it is just not sufficient enough to cope with the more contaminated units of blood which is only found out when the transX has progressed for a while and the mixed up bag gets settled to make the plasma float up IF I get a badly processed unit.

Yay!  I thought I was going to have to separate you two into two different corners.  hahaha.  Just kidding.   
Can we all hug now?   
I love you guys. 

Oh, we are all reasonable people here ..... we just let our passions get ahead of us sometimes!!! 

hi there
I am bappy from bangladesh.I have a transfution last 22 january,in this transfution i have a serious reaction. its couse of loss interest about eating, breath problem and etc. Do you have any suggetion for me,what i can do if i have anather reacton in next time.please suggest me..

bappy

Bappy,

It sounds like the blood was not properly matched. Where are you taking your transfusions?

HI there,
             I am very happy that you replay me.Ypu asked me where i have take transfution?
I take my transfution in read crisent socity.becouse its essy to get blood from there.Some
time i try to visit sir Dr.waqar kham and Dr.robin for some suggeation.My blood group is A+,
when it took reaction it massive effect in my body.last 13 days i loss 6 kg of my weaght.
I affried to take next transfution

I hope you give me some suggeation about this.


thanks
Bappy

Bappy,

Please call Dr Robin and explain what happened after your last transfusion. Tell him you are afraid to take blood until you know that it will be matched properly. Ask him where you can take blood and know it is safe.

Let me open this up. I know now many friends read with us.... so do not freak out.
I always complained about pain and feeling oh so cold? Well today I forgot to take my panadol (5oom) before my transfusion started..... I spiked a little fever about 38.2C & 38.4C and then we stopped measuring. I was crying because of the pain, it was so badly. Shortly after 38.2 I took my panadol. It helped, but it is weaning off now. The pain is worse again and I think I feel a bit "feverish". I will take a new panadol when I am more close to going to sleep. It's 10:52PM and I got an exam at 10Am. Last week I have been very sick and I had above problems. I have no clue what this is. You? I even start to think it may not be an allergy to blood as it occures now also without having a tanking up. Any thoughts are welcome. I would describe the pain as joint pain. But during tanking up I had a sharp, really intense, pain, on the middle left side of my body (for me left).

Thank you in advance.