Although a variety of strategies ranging from donor screening to compatibility testing and patient monitoring during hemotherapy (HT) exist to decrease transfusion complications, transfusion associated adverse events(TAAEs) can go undetected. Hemovigilance measures have been developed to capture many transfusion complications, however, even with these approaches, some adverse transfusion outcomes can occur days to weeks following HT, potentially compromising their detection. Two entities particularly challenging in this regard are delayed hemolytic transfusion reactions (DHTRs) and hyperhemolysis. Transfusion associated hyperkalemia (TAH), another potentially life-threatening rare complication of RBC transfusion may lead to severe cardiac comprise in patients and represents an TAAE that may have a particularly profound impact in pediatric patients. In this session we will explore common clinical presentations and pathophysiological mechanisms of DHTRs by examining the workup, diagnosis, transfusion support and management of DHTRs and hyperhemolysis. With respect to TAH we will explore its prevalence, characteristics of patients at particular risk, its morbidity and mortality, as well as the features of the blood units themselves and their associated infusion practices. Finally, we will highlight emerging opportunities to improve hemovigilance practices to capture these under-appreciated entities and potentially aid in their mitigation.
All relevant financial relationships have been mitigated.
Demonstrate that Delayed Hemolytic Transfusion Reactions (DHTRs) can occur in the absence of detectable alloantibodies and describe clinical and laboratory findings that support and differentiate the diagnoses of DHTRs and hyperhemolysis along with their respective managements
Describe various facets of Transfusion Associated Hyperkalemia (TAH) including its prevalence, diagnosis, and management
Identify gaps and barriers in the diagnosis and reporting of these under-recognized complications of hemotherapy that may help to inform and enhance hemovigilance monitoring systems
Chester Andrzejewski, Jr., PhD,MD,FCAP:
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