Washed RBCs Prevent Recurrent Acute Hypotensive Transfusion Reactions

Crews, William; Kay, Julie K.; Herman, Jay H.

doi:10.1309/ajcp9gvvozpdhh3h

Cited by 15 publications

(4 citation statements)

References 9 publications

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“…Treatment for a HyTR consists of stopping the transfusion, treating the hypotension, and providing supportive care 171,173 . The use of post‐storage blood product washing may also decrease the risk of HyTRs 176 …”

Section: Hypotensive Transfusion Reactions (Hytr)mentioning

confidence: 99%

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS). Part 1: Definitions and clinical signs

Davidow

Blois

Goy‐Thollot

et al. 2021

J Vet Emergen Crit Care

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Objective To use a systematic, evidence‐based consensus process to develop definitions for transfusion reactions in dogs and cats. Design Evidence evaluation of the literature was carried out for identified transfusion reaction types in dogs and cats. Reaction definitions were generated based on synthesis of human and veterinary literature. Consensus on the definitions was achieved through Delphi‐style surveys. Draft recommendations were made available through industry specialty listservs and comments were incorporated. Results Definitions with imputability criteria were developed for 14 types of transfusion reactions. Conclusions The evidence review and consensus process resulted in definitions that can be used to facilitate future veterinary transfusion reaction research.

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Section: Hypotensive Transfusion Reactions (Hytr)mentioning

confidence: 99%

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS). Part 1: Definitions and clinical signs

Davidow

Blois

Goy‐Thollot

et al. 2021

J Vet Emergen Crit Care

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“…Hypotension usually resolves once the transfusion is stopped [ 13 ]. According to Crews et al [ 14 ] washing the red cells may prevent recurrent reactions, presumably by removing the activated Factor XII and other AHTR-initiating substances. However, washed packed RBCs take several hours to prepare and have a short shelf life.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Diagnosis and Management of Acute Hypotensive Blood Transfusion Reaction (AHTR): A Report of Two Cases

et al. 2018

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Case seriesPatients: Female, 68 • Male, 86Final Diagnosis: Acute hypotensive transfusion reactionSymptoms: HypotensionMedication: —Clinical Procedure: —Specialty: AnesthesiologyObjective:Challenging differential diagnosisBackground:Acute hypotensive transfusion reaction (AHTR) is characterized by the abrupt onset of hypotension immediately after the start of transfusion and usually resolves when transfusion ceases. Recent studies have shown an association with pre-operative treatment with an angiotensin-converting enzyme (ACE) inhibitor. This report presents two cases of AHTR in non-related patients and describes the diagnosis and management.Case Report:A 68-year-old woman underwent lumbar fusion surgery due to spinal stenosis and an 86-year-old man underwent a pancreaticoduodenectomy (Whipple’s procedure). Both patients had been treated pre-operatively with ACE inhibitors for hypertension. During surgery, both patients experienced acute profound intraoperative hypotension immediately after transfusion of packed red blood cells (RBCs). The blood transfusion was stopped immediately, and hemodynamic support was given with epinephrine, ephedrine, and phenylephrine. A diagnosis of acute hemolytic transfusion reaction was excluded by the direct antiglobulin test, serum hemolysis testing, exclusion of blood group mismatching, and a post-transfusion antibody screen. Other causes of hypotension were excluded. The two patients were confirmed t have had an AHTR, based on the current Centers for Disease Control and Prevention (CDC) criteria. In both cases, discontinuation of surgery was not possible, and surgery continued with intermittent hemodynamic support provided with catecholamines and vasopressin.Conclusions:AHTR is a diagnosis of exclusion, based on laboratory and clinical findings. Antibody-mediated acute hemolytic transfusion reaction and any other causes of hypotension should be excluded as rapidly as possible. Patients who are at high risk of intraoperative bleeding might benefit from cessation of ACE inhibitors pre-operatively.

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“…Although changes in leucoreduction practices have resulted in a significant decrease in the incidence of acute hypotensive transfusion reactions , events are still reported . Storage of PCs appears to enhance BK production .…”

Section: Discussionmentioning

confidence: 99%

Incidence of hypotension and acute hypotensive transfusion reactions following platelet concentrate transfusions

et al. 2015

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Washed RBCs Prevent Recurrent Acute Hypotensive Transfusion Reactions

Abstract: Our experience suggests that washing the products was an acceptable and effective preventative measure to avoid further acute hypotensive transfusion reactions in patients unable to metabolize these vasodilators present in the donor units.

Cited by 15 publications

References 9 publications

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS). Part 1: Definitions and clinical signs

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS). Part 1: Definitions and clinical signs

Intraoperative Diagnosis and Management of Acute Hypotensive Blood Transfusion Reaction (AHTR): A Report of Two Cases

Incidence of hypotension and acute hypotensive transfusion reactions following platelet concentrate transfusions

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