DOWNSIDE OF BLOOD FOR BLOOD

6. The Blood GROUPS

There are four types of groups:

1. Group A (red cells contain A agglutinogens, serum contain
Anti B agglutinins)
2. Group B (red cells contain B agglutinogens, serum contain
Anti A agglutinins)
3. Group AB (red cells contain both A and B agglutinogens,
serum contains no agglutinins)
4. Group O (red cells have no A or B agglutinogens, serum
contains both Anti A and Anti B agglutinins)

7. COMPLICATIONS OF TRANSFUSION

7.1 ABO Incompatibility

The most important complication resulting in loss of life is the
transfusion reaction, because of A, B, O incompatibility.
Most of these are events that result from clerical errors
-when the correct cross match has not been made or
-correct group had not been indicated on supplied blood.
In many cases the correct patient has not been
Identified in the ward.

These errors are preventable by installing ward and laboratory
procedures wherein no errors can occur.

When such transfusion reaction is suspected the transfusion should
be stopped and the urine be tested for Hemoglobin.
The blood bank should recheck the samples and record the event to identify the cause of the mismatch.

The patient should receive fluids to correct hypotension and
maintain renal blood flow.
Mannitol may be useful for diuresis.

7.2 IMMUNE REACTIONS

7.2.1 HEMOLYTIC

These reactions occur as a delayed reaction after the
transfusion has been completed.

-There is fall in hematocrit and it is accompanied by fever and
Jaundice.
-This jaundice may be caused by the antibodies to earlier
transfusions.
It may also be because of mishandled blood packs or infected blood packs.
7.2.2 NON-HEMOLYTIC REACTIONS

Erythma,
Urticaria,
Pruritus, occur within a few minutes of start
of transfusion.
-These are allergic reactions and the symptoms are due to release of Histamine and Serotonin as result of antigen-antibody reaction.
Transfusion is slowed down, and anti-histamine is given.
If no progress of symptoms occurs the transfusion can be continued.
7.2.3 ANAPHYLACTIC REACTION

The symptoms include

* Respiratory distress Bronchospasm
* Hypertension later Hypotension
* Subcutaneous edema

These are caused by antigen-antibody reaction and complement
activation and treated by:
1. Stop transfusion
2. Start isotonic saline
3. Anti-Histamine intravenously
4. Cortico-steroid 100 mg. hydrocortisone IV
5. Oxygen
6. Give diuretics eg. Furosemide. IV

7.3 TRANSMISSION OF DISEASE

Viral and bacterial infection can be transmitted by blood
transfusion.
This is possible if proper screening procedures for
donors are not conducted.

7.3.1 HUMAN IMMUNODEFICIENCY VIRUS

If screening of donar for HIV is not conducted this virus can be
transmitted through blood transfusion.

Awareness of prevalence of HIV in the population and screening
Procedure will bring down this mode of transmission.
Any questions be sent to drmmkapur@gmail.com