1What is likely to happen if a patient given mismatched blood?
Transfusion of mismatched blood can lead to a potentially life threatening condition called a hemolytic transfusion reaction. Here's what typically happens when mismatched blood is given:
Immediate Reaction:
- Within minutes to hours after the transfusion, the patient may experience chills, fever, anxiety, and shortness of breath.
Hemolysis:
- The incompatible antibodies present in the recipient's plasma attack the transfused red blood cells causing their breakdown (hemolysis). Hemoglobin and cell debris are released into the bloodstream.
DIC and Kidney Damage:
- The release of hemoglobin and cell fragments can trigger disseminated intravascular coagulation (DIC), a condition where abnormal clotting occurs throughout the body.
- DIC can lead to widespread bleeding and organ damage, including kidney failure.
Splenomegaly and Jaundice:
- The spleen plays a role in removing damaged red blood cells from circulation. In response to the hemolysis, the spleen can enlarge (splenomegaly).
- As the liver processes the broken-down hemoglobin, excessive bilirubin accumulates, causing jaundice (yellowing of the skin and eyes).
Renal Failure and Shock:
- The damaged red blood cells, cell debris, and hemoglobin overload can clog the kidneys tubules causing acute renal injury and potentially leading to kidney failure.
- The accumulation of toxic substances and loss of blood volume can cause circulatory shock and a drop in blood pressure.
Treatment:
In the event of a hemolytic transfusion reaction, the transfusion is immediately stopped, and supportive measures are initiated:
- Intravenous fluids to maintain circulation and prevent kidney damage.
- Medications to control fever and combat shock.
- Treatment for disseminated intravascular coagulation, if necessary.
- In severe cases, exchange transfusion may be required to remove the incompatible blood and replace it with compatible blood.
Prevention remains crucial to avoid mismatched blood transfusions. Careful patient identification, thorough blood typing and cross-matching procedures, and strict adherence to transfusion protocols are essential to ensure patient safety.