Öz
Ölümcül hemolitik transfüzyon reaksiyonu prevalansı yaklaşık olarak ünite başına1:200000`dir. Kan ürünü alırken ya da yirmidört saat içinde ortaya çıkan hemolitiktransfüzyon reaksiyonu genellikle uygunsuz eritrosit süspansiyonu ve nadiren yüksekvolümlü plazma transfüzyonu sonrasında oluşur. Gecikmiş hemolitik transfüzyonreaksiyonu verici eritrositlerindeki antijenlere karşı ikincil immun yanıta bağlıdır.İnkomplet kompleman aktivitasyon sonucu C3b ile kaplı eritrositlerin makrofajlarcafagositozu ya da Ig G kaplı eritrositlerin direkt hücre hücre etkileşimi ile doğal öldürücühücrelerce yıkılması gibi farklı mekanizmalar intra ya da ekstra vasküler yıkıma yolaçar. Hemolitik transfüzyon reaksiyonları klinik sonuçları değişik patolojik yolaklarınçalışmasıyla olur. Anafilatoksin formasyonu, sitokinlerin salınımı, kinin sistemi,intrinsik koagülasyon kaskadı ve fibrinolizis aktivasyonu sonucu sistemik inflamatuaryanıt meydana gelir. Mikrosirkülasyonda bozulma sonucunda hipotansiyon, dissemineintravasküler koagülasyon, yaygın kanama, renal yetmezlik ve şok tablosu ortaya çıkar.Bu derlemede hemolitik transfüzyon reaksiyonu semptomları geliştiğinde yapılmasıgereken laboratuvar çalışmaları, tedavi yaklaşımı ve önlemek için neler yapılabileceği vurgulanmıştır
Anahtar Kelimeler
Kaynakça
- 1. Williamson LM, Lowe S, Love EM, Cohen H, Soldan K, McClelland DB et al. Serious hazards of transfusion (SHOT) initiative: analysis of the first two annual reports. BMJ 1999;319:16-9.
- 2. Sesok DA. Acute and Delayed Hemolytic Transfusion Reactions. In: Hillyer CD, Hillyer KL, Strobl FJ, Jefferies LC, Silberstein LE eds. Handbook of Transfusion Medicine. California: Academic Pres, 2001: 248-50.
- 3. Baughn MR, Whitacre P, Lo GS, Pandey S, Lane TA. A mild acute hemolytic transfusion reaction in a patient with alloanti-Ge3: a case report and review of the literature. Transfusion 2011;51:1966-71.
- 4. Goodell PP, Uhl L, Mohammed M, Powers AA. Risk of hemolytic transfusion reactions following emergencyrelease RBC transfusion. Am J Clin Pathol 2010;134:202-6.
- 5. Irani MS, Richards C. Hemolytic transfusion reaction due to anti-IH. Transfusion 2011;51:2676-8.
- 6. Xu Z, Duffett L, Tokessy M, Cote J, Goldman M, Saidenberg E. Anti-AnWj causing acute hemolytic transfusion reactions in a patient with aplastic anemia. Transfusion 2012.[Epub ahead of print]
- 7. Sloan S. Friedman DF, Kao G, Kaufman RM, Silberstein L. Adverse Effects of transfusion. In: Orkin SH, Fisher DE, Look AT, Lux SE, Ginsburg D, Nathan DG eds. Hematology of Infancy and Childhood, 7 th edition. Philadelphia: Saunders Elsevier, 2009:1636-8.
- 8. Eder AF. Transfusion Reactions. In: Hillyer CD, Strauss RG, Luban NLC eds. Handbook of Pediatric Transfusion Medicine. California: Academic Pres, 2004;301-15.
- 9. Strobel E. Hemolytic Transfusion Reactions. Transfus Med Hemother 2008;35:346-53.
- 10. Huber-Lang M, Sarma JV, Zetoune FS, Rittirsch D, Neff TA, McGuire SR et al. Generation of C5a in the absence of C3: a new complement activation pathway. Nat Med 2006;12:682-7.
- 11. Hod EA, Cadwell CM, Liepkalns JS, Zimring JC, Sokol SA, Schirmer DA et al. Cytokine storm in a mouse model of IgGmediated hemolytic transfusion reactions. Blood 2008;112:891-4.
- 12. Engelfriet CP. Blood Transfusion Reactions. In: Roitt IM, Delves PJ. Encyclopedia of Immunology. Academic Press, 2004;346-9.
- 13. Aronson JK. Blood cell transfusion and bone marrow transplantation Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions. Oxford, Elsevier 2006;529-44.
- 14. Whitsett CF. Transfusion Reaction. In: Reed AP, Yudkowitz FS. Clinical Cases in Anesthesia, Third Edition; 2005;269-78.
- 15. Wadhwa M, Seghatchiany J, Thorpe R. Are Cytokines in Platelet Concentrates Responsible for Febrile Transfusion Reactions Transfus Sci 1997;18:367-71.
- 16. Bryan S. Hemolytic Transfusion Reaction: Safeguards for Practice. J Perianesth Nurs 2002;17:399-403.
- 17. Josephson CD, Hillyer CD. Acute hemolytic transfusion reactions. In: Hillyer CD, Shaz BH, Zimring JC. Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects. First edition; California, Elsevier, 2009; Chapter 55;317-21.
- 18. Öztürk G. Pediatride transfüzyon pratiği.Ed: Anak S, Aydoğan G,Çetin M. Pediatrik Hematoloji. Birinci baskı; İstanbul, İstanbul Medikal Yayıncılık, 2011; Bölüm 12; 925-45.
- 19. de Montalembert M, Dumont MD, Heilbronner C, Brousse V, Charrara O, Pellegrino B et al. Delayed hemolytic transfusion reaction in children with sickle cell disease. Haematologica 2011;96:801-7.
- 20. Talano JA, Hillery CA, Gottschall JL, Baylerian DM, Scott JP. Delayed hemolytic transfusion reaction/hyperhemolysis syndrome in children with sickle cell disease. Pediatrics. 2003;111:e661-5.
- 21. Heddle NM. Pathophysiology of febrile nonhemolytic transfusion reactions. Curr Opin Hematol 1999;6:420-6.
- 22. Josephson CD. Febrile Non-hemolytic Transfusion Reactions. In: Hillyer CD, Shaz BH, Zimring JC. Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects. First edition; California, Elsevier, 2009; Chapter 53; 309-10.
- 23. Jamaali F and Ness PM. İnfections Complication, Handbook of Pediatric Transfusion Medicine, California: Academic Pres, 2004; Chapter 28; 329-43.
- 24. Massey E PG. Haemolytic transfusion reactions. In: Murphy MF PD. Practical Transfusion Medicine. Third edition; Blackwell Publishing; 2009; Chapter 7; 72-80.
Öz
The prevalence of fatal hemolytic transfusion reactions HTRs is approximately1:200000 per unit. Acute HTRs occur during or within 24 h after administration of a bloodproduct. Transfusion of incompatible red blood cells RBCs , and, more rarely, of a largevolume of incompatible plasma usually are the causative agents. Delayed HTRs arecaused by a secondary immune response to an antigen on the donor’s RBCs. Differentmechanisms lead to intra- and extravascular hemolysis, such as complete complementactivation, phagocytosis of RBCs covered with C3b by macrophages after incompletecomplement activation, or destruction of RBCs covered only with IgG by direct cell tocell contact with K cells. The clinical consequences of HTRs are triggered via severalpathophysiological pathways. Formation of anaphylatoxins, release of cytokinescausing a systemic inflammatory response syndrome, activation of the kinin system, theintrinsic clotting cascade and fibrinolysis result in hypotension, disseminatedintravascular coagulation, diffuse bleeding, and disruption of microcirculation leadingto renal failure and shock. In this review, the symptoms of HTR are introduced,laboratory investigations and treatment are described, and some recommendations forprevention are given
Anahtar Kelimeler
Kaynakça
- 1. Williamson LM, Lowe S, Love EM, Cohen H, Soldan K, McClelland DB et al. Serious hazards of transfusion (SHOT) initiative: analysis of the first two annual reports. BMJ 1999;319:16-9.
- 2. Sesok DA. Acute and Delayed Hemolytic Transfusion Reactions. In: Hillyer CD, Hillyer KL, Strobl FJ, Jefferies LC, Silberstein LE eds. Handbook of Transfusion Medicine. California: Academic Pres, 2001: 248-50.
- 3. Baughn MR, Whitacre P, Lo GS, Pandey S, Lane TA. A mild acute hemolytic transfusion reaction in a patient with alloanti-Ge3: a case report and review of the literature. Transfusion 2011;51:1966-71.
- 4. Goodell PP, Uhl L, Mohammed M, Powers AA. Risk of hemolytic transfusion reactions following emergencyrelease RBC transfusion. Am J Clin Pathol 2010;134:202-6.
- 5. Irani MS, Richards C. Hemolytic transfusion reaction due to anti-IH. Transfusion 2011;51:2676-8.
- 6. Xu Z, Duffett L, Tokessy M, Cote J, Goldman M, Saidenberg E. Anti-AnWj causing acute hemolytic transfusion reactions in a patient with aplastic anemia. Transfusion 2012.[Epub ahead of print]
- 7. Sloan S. Friedman DF, Kao G, Kaufman RM, Silberstein L. Adverse Effects of transfusion. In: Orkin SH, Fisher DE, Look AT, Lux SE, Ginsburg D, Nathan DG eds. Hematology of Infancy and Childhood, 7 th edition. Philadelphia: Saunders Elsevier, 2009:1636-8.
- 8. Eder AF. Transfusion Reactions. In: Hillyer CD, Strauss RG, Luban NLC eds. Handbook of Pediatric Transfusion Medicine. California: Academic Pres, 2004;301-15.
- 9. Strobel E. Hemolytic Transfusion Reactions. Transfus Med Hemother 2008;35:346-53.
- 10. Huber-Lang M, Sarma JV, Zetoune FS, Rittirsch D, Neff TA, McGuire SR et al. Generation of C5a in the absence of C3: a new complement activation pathway. Nat Med 2006;12:682-7.
- 11. Hod EA, Cadwell CM, Liepkalns JS, Zimring JC, Sokol SA, Schirmer DA et al. Cytokine storm in a mouse model of IgGmediated hemolytic transfusion reactions. Blood 2008;112:891-4.
- 12. Engelfriet CP. Blood Transfusion Reactions. In: Roitt IM, Delves PJ. Encyclopedia of Immunology. Academic Press, 2004;346-9.
- 13. Aronson JK. Blood cell transfusion and bone marrow transplantation Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions. Oxford, Elsevier 2006;529-44.
- 14. Whitsett CF. Transfusion Reaction. In: Reed AP, Yudkowitz FS. Clinical Cases in Anesthesia, Third Edition; 2005;269-78.
- 15. Wadhwa M, Seghatchiany J, Thorpe R. Are Cytokines in Platelet Concentrates Responsible for Febrile Transfusion Reactions Transfus Sci 1997;18:367-71.
- 16. Bryan S. Hemolytic Transfusion Reaction: Safeguards for Practice. J Perianesth Nurs 2002;17:399-403.
- 17. Josephson CD, Hillyer CD. Acute hemolytic transfusion reactions. In: Hillyer CD, Shaz BH, Zimring JC. Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects. First edition; California, Elsevier, 2009; Chapter 55;317-21.
- 18. Öztürk G. Pediatride transfüzyon pratiği.Ed: Anak S, Aydoğan G,Çetin M. Pediatrik Hematoloji. Birinci baskı; İstanbul, İstanbul Medikal Yayıncılık, 2011; Bölüm 12; 925-45.
- 19. de Montalembert M, Dumont MD, Heilbronner C, Brousse V, Charrara O, Pellegrino B et al. Delayed hemolytic transfusion reaction in children with sickle cell disease. Haematologica 2011;96:801-7.
- 20. Talano JA, Hillery CA, Gottschall JL, Baylerian DM, Scott JP. Delayed hemolytic transfusion reaction/hyperhemolysis syndrome in children with sickle cell disease. Pediatrics. 2003;111:e661-5.
- 21. Heddle NM. Pathophysiology of febrile nonhemolytic transfusion reactions. Curr Opin Hematol 1999;6:420-6.
- 22. Josephson CD. Febrile Non-hemolytic Transfusion Reactions. In: Hillyer CD, Shaz BH, Zimring JC. Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects. First edition; California, Elsevier, 2009; Chapter 53; 309-10.
- 23. Jamaali F and Ness PM. İnfections Complication, Handbook of Pediatric Transfusion Medicine, California: Academic Pres, 2004; Chapter 28; 329-43.
- 24. Massey E PG. Haemolytic transfusion reactions. In: Murphy MF PD. Practical Transfusion Medicine. Third edition; Blackwell Publishing; 2009; Chapter 7; 72-80.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Collection |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Haziran 2012 |
| Yayımlandığı Sayı | Yıl 2012 Cilt: 10 Sayı: 1 |