Post-Transfusion Reaction

Vanda Benetinová, MD, Nikola Cíchová, MD, Ema Vícenová, Ivan Murín
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Post-Transfusion Reaction

Administration of blood products is a routine yet potentially high-risk situation in clinical practice. Even with correct indication and careful preparation, a patient’s condition may change unexpectedly, requiring rapid assessment of the current situation and appropriate decision-making. Early symptoms are often subtle, non-specific, and easily overlooked — yet this is the crutial moment for further course of treatment and patient outcome. 

2026
transfusion reaction
differential diagnosis
patient safety
Published at: 20.8.2026

Review

Pavel Ježek, MD
Pavel Ježek, MD

The algorithm for post-transfusion reactions is well-structured, including therapeutic procedures and a differential diagnosis. It clearly outlines the basic risks and how to manage complications connected to the administration of trasnfusion. Every doctor who administers transfusions in their practice must be able to manage these situations and, simultaneously, must understand the importance of the correct handling of blood products and the need for reporting potential transfusion reaction within the hospital system of haemovigilance.

Sources

PENKA, Miroslav, et al., 2011. Hematologie a transfuzní lékařství I: Hematologie. Praha: Grada Publishing. ISBN 978-80-247-3459-0.

ŘEHÁČEK, Vít and Jiří MASOPUST, 2013. Transfuzní lékařství. Praha: Grada Publishing. ISBN 978-80-247-4530-5.

PECK, Magali J., 2014. Technician's Guide to Transfusion Medicine. 4th ed. Bethesda: AABB Press. ISBN 978-1563958854.

SPOLOČNOSŤ PRE TRANSFÚZNE LEKÁRSTVO ČLS JEP, 2021. Doporučený postup pro vyšetřování a hlášení potransfuzních reakcí [online]. [Accessed 2026-04-07]. Available from: https://www.stls.cz/

PÍSAČKA, Martin, 2018. Bed-side testy a jejich význam v bezpečnosti transfuzního procesu. Transfuze a hematologie dnes. vol. 24, no. 2, pp. 112–118. ISSN 1213-5763.

VLAAR, Alexander P., et al., 2019. Diagnostic criteria for transfusion-related acute lung injury (TRALI): a modified Delphi redefinition. The Lancet Haematology. vol. 6, no. 11, pp. e576–e584. ISSN 2352-3026.

Learning targets

1. The student is able to recognize early signs of a post-transfusion reaction and is aware of the variability of its clinical presentation.
2. The student knows how to respond appropriately when an acute post-transfusion reaction is suspected.
3. The student understands the basic principles of management of acute conditions associated with post-transfusion reactions.
4. The student understands the importance of proper handling of transfusion materials and the necessity of reporting within the hemovigilance system.

Key points

1. The physician verifies patient identity, documentation, and bag integrity. For erythrocyte products, a bedside test is mandatory.
2. If a reaction is suspected, stop the transfusion immediately. Report any potential misidentification to the transfusion service without delay.
3. Send the transfusion reaction report along with the remaining product in its original bag and a post-reaction blood sample from the recipient.
4. Keep the empty bag in a refrigerator for 24 hours in case of a delayed reaction.

Related algorithms

Algorithms