Guidelines for the Evaluation and Diagnosis of Transfusion Reactions

By Wen Lu, MD; Peter R. Pelletier, MD; Kathleen Puca, MD; Glenn Ramsey, MD; and NurJehan Quraishy, MD for the Transfusion Medicine Section Coordinating Committee

The evaluation and diagnosis of a suspected transfusion reaction requires clinical judgment by a physician trained in adverse effects of transfusion. Importantly, negative testing results do not necessarily exclude a reaction if there is strong suspicion that the patient’s symptoms are related to blood transfusion. The laboratory evaluation of these events is crucial not only for the patient’s health but also for corrective and preventive actions that are part of process improvement.

The AABB Guide to the Laboratory Evaluation of Transfusion Reactions serves as a comprehensive resource, providing step-by-step guidance for the diagnosis and management of various transfusion reactions, including:

Types of Transfusion Reactions

• Hemolytic Transfusion Reactions
• Transfusion-Related Acute Lung Injury (TRALI)
• Transfusion-Associated Circulatory Overload (TACO)
• Allergic/Anaphylactic Reactions
• Septic Transfusion Reactions
• Posttransfusion Purpura
• Iron Overload
• Transfusion-Associated Graft-vs-Host Disease (TA-GVHD)

This updated reference also features an extremely useful appendix, which summarizes common acute and delayed transfusion reactions, including their primary symptoms, additional symptoms, usual timing of onset, initial laboratory evaluation, and confirmatory/supplemental evaluations.

Stay up-to-date with the latest guidelines and best practices in transfusion medicine with the AABB Guide to the Laboratory Evaluation of Transfusion Reactions. This invaluable resource is available in a digital edition, published in 2021 by AABB.