Transfusion Reaction Workup


Sunquest Code:TRX  
Epic Code:LAB893Epic Name:Transfusion Reaction Evaluation
Order Instructions:OrderTRXH for transfusion reaction hives.
Synonyms:Blood Reaction; Hemolytic Transfusion Reaction; Reaction, Blood
CPT Code:86078
Test Includes:Clerical check. On post reaction blood specimen, visual examination for serum hemoglobin and bilirubin, direct antiglobulin test, and ABO/Rh(D) typing. Further investigation may include culture and gram stain of donor blood, antibody detection test, or crossmatch.
Turnaround Time:Initial investigation is performed stat; preliminary report is available same day.
Special Instructions:The following symptoms occurring within 2 hours after infusion may indicate a transfusion reaction: chills, fever, nausea, vomiting, hives, rash, abdominal or lumbar pain, headache, pain along the vein being used for infusion, respiratory distress, cyanosis, hyper-hypotension, tachycardia, red urine, excessive bleeding, pulmonary edema. (Refer to Transfusion Guidelines in the Appendix.) Mild to moderate reaction to products cryopreserved in DMSO is not considered an adverse reaction. (Refer to the UMMC Nursing Policy Manual: Blood and Marrow Transplant Products: Procedure for Administration.)


Collection Instructions

Specimen:Blood
Optimal Volume:4 mL
Minimum\Peds Volume:2 mL
Collection Instructions:In case of reaction, stop transfusion, notify Blood Bank and patient's physician immediately. Order "Transfusion Rxn Blood Bank Notificatin" in Epic. Send the following to the laboratory: blood product container(s) closed securely with infusion set and any attached intravenous solutions and one 4 mL EDTA tube post-reaction specimen or contact lab to draw). If hives are the only sign of a reaction and they resolve after medication is given, transfusion may be restarted without lab evaluation, at the discretion of the patient's physician. All other transfusions must not be restarted without evaluation by a Blood Bank physician.


Processing and Shipping

Test Performed at or Referral Lab Blood Bank  (UMMC-East Bank, Fairview Lakes - FLMC, Fairview Ridges - FRH, Fairview Northland - FNMC, Fairview Southdale - FSH, UMMC/UMMCH-West Bank, UMMC NICU)


Interpretive

Reference Range:Evaluation of the report is performed by Blood Bank physician.
Use:Investigate cause of possible transfusion reactions, e.g. urticarial reaction to unknown protein; nonhemolytic febrile transfusion reaction; delayed hemolysis, incompatible RBC; acute hemolysis, incompatible RBC; TRALI, or no apparent transfusion-related cause.


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