Transfusion Medicine Services
Our dedicated professionals provide a wide range of consultative services in hospitals and through special products and services to patients with bleeding disorders.
- Post-Transfusion Adverse Events
Though not all transfusion-related adverse events need to be reported to RIBC, RIBC will investigate all reported suspected post-transfusion adverse events and communicate the findings to the hospital. Our specialists are available 24/7 to report any post-transfusion complications at 401-453-8374.
Please fill out our Suspected Transfusion Related Adverse Events Report form and email it to firstname.lastname@example.org or fax it to 401-248-5750.
POST-TRANSFUSION ADVERSE EVENTS REQUIRING REPORTING TO NYBC
Septic Reactions: Bacterial contamination of blood products may result in bacterial infection of the recipient, resulting in fever and other signs of sepsis. Platelet products have the highest risk of bacterial contamination followed by red blood cell products. Upon reporting a septic reaction or potentially bacterially contaminated product, RIBC will recall all other products from that donation. To mitigate these reactions, RIBC disinfects donor's arms, diverts the initially 30-50 ml of drawn blood, and cultures all platelet products.
Transfusion-Related Acute Lung Injury: Transfusion-related acute lung injury is most commonly due to donor antibodies to white blood cells antigens (HLA and HNA) resulting in shortness of breath, fever, and hypotension. Upon reporting a case to RIBC, we will evaluate donors for white blood cell antibodies. We can also provide molecular testing of the recipient's white blood cell antigens to see if they match. To mitigate these reactions, RIBC's plasma and apheresis platelet products are predominately from low-risk donors (males, never-pregnant females, or HLA antibody negative previously pregnant females).
Transfusion Transmitted Diseases: Transfusion transmitted diseases include HIV, hepatitis B and C viruses, Human T-cell lymphotropic virus (HTLV-I/II), cytomegalovirus, West Nile virus, syphilis, babesiosis, and Chagas' disease, among others. The blood supply is the safest it has ever been due to testing of donors for a variety of infections and taking donor histories to ensure the people who donate are well. Upon receipt of a potential infectious transmission from donor to recipient, RIBC may defer the donor and test the donor for the suspected infection. To mitigate transfusion transmitted diseases, RIBC tests donors for HIV, hepatitis B and C viruses, HTLV-I/II, syphilis agent, Chagas' disease agent, West Nile virus, babesia microti and ZIKA virus. Additionally, RIBC leukoreduces all blood components.
POST-TRANSFUSION ADVERSE EVENTS NOT REQUIRING REPORTING TO RIBC
Allergic Reactions: Allergic reactions are due to recipient antibodies to donor plasma proteins. Allergic reactions can result in a broad spectrum of severity from focal mild urticarial to systemic, life-threatening anaphylaxis. To mitigate these reactions, RIBC can provide washed products to nearly eliminate plasma in red cell and platelet products or platelets stored in additive solution with less plasma.
Hemolytic Reactions: Transfusion of incompatible red blood cells or plasma can lead to hemolysis. These reactions can be secondary to ABO-incompatibility or other minor red cell antigens. Hemolytic reactions can be acute, occurring immediately, or delayed, occurring days to weeks after the transfusion, and result in fever, chills, and back pain. To mitigate these reactions, RIBC ensures blood components are labeled appropriately and providing red cell antigen negative units for alloimmunized patients upon request.
Febrile Non-Hemolytic Reactions: Febrile non-hemolytic transfusion reactions are defined as a temperature increase of 1 degree C or greater associated with a transfusion with or without chills/rigors. These are due to either white blood cells or cytokines in the product. To mitigate these reactions, RIBC leukoreduces all blood components.
Post-Transfusion Purpura: Post-transfusion purpura, which occurs rarely, is secondary to recipient platelet antibodies against transfused platelet antigens resulting in severe thrombocytopenia. To mitigate these reactions, RIBC leukoreduces all blood components, which may help.
Transfusion-Associated Circulatory Overload: Transfusion-associated circulatory overload results from circulatory overload following transfusion. Symptoms include dyspnea, orthopnea, hypertension, headache, and cyanosis.
Transfusion- Associated Graft-Versus-Host Disease: Transfusion-associated graft versus host disease is a rare, but highly fatal complication of transfusion. This occurs when donor lymphocytes engraft into a recipient resulting in decreased blood counts, rash, and diarrhea. To mitigate these reactions, RIBC can irradiate products for high risk recipients, like those with immunodeficiency syndromes, hematologic malignancies, and on certain immunosuppressive medications. RIBC can irradiate components, which prevent this complication.