Febrile non-hemolytic transfusion reaction

Febrile non-hemolytic transfusion reaction
Classification and external resources
ICD-10 Y44.6, Y44.7

Febrile non-hemolytic transfusion reaction is a type of transfusion reaction that is associated with fever but not directly with hemolysis. It is most commonly caused by antibodies directed against donor leukocytes and HLA antigens. This is in contrast to transfusion-associated acute lung injury, in which the donor plasma has antibodies directed against the recipient HLA antigens, mediating the characteristic lung damage. Alternatively, FNHTR can be mediated by pre-formed cytokines in the donor plasma as a consequence of white blood cell breakdown.[1][2]

It is abbreviated "FNHTR".[3]

Symptoms must occur either during or within 4 hours of cessation of the transfusion and fever must be ≥ 38C/100.4F oral and a change of at least 1C/1.8C from pre-transfusion value or chills and/or rigors must be present according to the Centers for Disease Control (CDC) National Healthcare Safety Network Biovigilance Component Hemovigilance Module Surveillance Protocol[4].

Acetaminophen has been used in treatment, and leukoreduction of future transfusions is sometimes performed.[5]

References

  1. ↑ Addas-Carvalho M, Salles TS, Saad ST (June 2006). "The association of cytokine gene polymorphisms with febrile non-hemolytic transfusion reaction in multitransfused patients". Transfus Med. 16 (3): 184–91. doi:10.1111/j.1365-3148.2006.00665.x. PMID 16764597.
  2. ↑ Yazer MH, Podlosky L, Clarke G, Nahirniak SM (January 2004). "The effect of prestorage WBC reduction on the rates of febrile nonhemolytic transfusion reactions to platelet concentrates and RBC". Transfusion. 44 (1): 10–5. doi:10.1046/j.0041-1132.2003.00518.x. PMID 14692961.
  3. ↑ Heddle NM (November 1999). "Pathophysiology of febrile nonhemolytic transfusion reactions". Curr. Opin. Hematol. 6 (6): 420–6. doi:10.1097/00062752-199911000-00012. PMID 10546797.
  4. ↑ "NHSN | CDC". www.cdc.gov. 2017-12-29. Retrieved 2018-09-18.
  5. ↑ "Complications of Transfusion: Transfusion Medicine: Merck Manual Professional". Retrieved 2009-02-09.
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