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transfusion 714 transfusion reactions
transfusion
The transplantation of blood cells, platelets, and/or plasma
from the circulation of one individual to another. Acute
blood loss due to hemorrhage or the replacement of deficient
cell types due to excess destruction or inadequate formation
are indications for transfusion. With the description
of human blood groups by Landsteiner in 1900, the transfusion
of blood from one human to another became possible.
This ability ushered in the field of transfusion medicine
concerned with substitution therapies with human blood,
protein deficiencies, and blood loss. Peripheral blood cell
and plasma collection, processing, storage, compatibility
matching, and transfusion are routine procedures in medical
centers throughout the world. The descriptions of other
blood group systems followed the initial description of the
ABO types. Modern blood group serology and immunohematology
laboratories consider all aspects of allo- and
autoantibodies against red cells in clinical transfusion.
Blood-borne viruses are recognized as critical risk factors
in transfusion. In recent years, the rate of viral transmission
through transfusions has greatly diminished with the development
of adequate screening for human immunodeficiency
virus (HIV), hepatitis viruses, and other infectious agents.
Early dog blood transfusion.
Transfusion of patient with animal blood. (From Scultatus, courtesy of
National Library of Medicine.)
transfusion-associated graft-vs.-host disease (TAGVHD)
Infused immunocompetent T lymphocytes react against
histoincompatible immune system cells of a recipient. This
is likely to occur in patients who have been immunocompromised
or are receiving chemotherapy for tumors. Patients
Engraved title page from G.A. Merklin’s Tractatio Med: Curiousa de
Ortu et Sanguinis, 1679. This is one of the best early depictions of blood
transfusion. (From the Cruse Collection, Middleton Library, University of
Wisconsin.)
Transfusion chair developed by James Blundell, the father of modern blood
transfusion therapy.
may develop skin rashes and have profound pancytopenia and
altered liver function tests. Three weeks following transfusion,
84% may die. To avoid graft-vs.-host reactivity induced
by a transfusion, any blood product containing lymphocytes
should be subjected to 1500 rad prior to administration.
transfusion effect
Facilitation of organ transplant acceptance by a recipient
who received prior blood transfusions from individuals
sharing an HLA-DR allotype with the organ donor.
transfusion reactions
Immune and nonimmune reactions that follow the administration
of blood. Transfusion reactions with immune
causes are considered serious and occur in 1 in 3000
transfusions. Patients may develop urticaria, itching, fever,