Fever during/after transfusion

[Mseth]

Hello all,

Need some advice from others receiving red cell transfusions.
Every once in a while, my mother develops a fever after transfusion. She receives 2 units at one time. Sometimes the fever comes on towards the end of the 2nd unit, or sometimes the next day. A few months back the fever persisted for a week, she was put on antibiotic at that time. Normally a paracetamol or an advil(ibuprofen) brings it down. I have read that fever is the most common side effect after transfusion, and the daycare doctors say it is normal. But is there any premedication that can help? She receives leucoreduced pRBC, she can also get leucodepleted pRBC, but develops some unexplainable high potassium levels when she gets the leucodepleted ones.
Her WBC are normal and she has rarely ever had fevers/chills in her lifetime.

Thanks for any advice.

[riccd2001]

Since starting PRBC transfusions in 2008, I have had only a few "problems" which have been caused by "least incompatible" units. For me this was resolved by having only "combatible" donor PRBC transfusions; so I have to have my blood tested a day in advance of receiving PRBCs. This extra time allow the blood bank to find "combatible" PRBCs.

In addition, I have the following pre-meds: 2 regular tylenol, 2 benadryl 25mg, and 100ml IV hydrocortisone. And since then (April 2008) I've had over 250 units transfused without any problems.

Check with her doc. - maybe some pre-meds would help your mom?

[Mseth]

Hi Ric,

Thanks for responding. Good to read that you have no problem with transfusions after the premeds

The doctor is aware of the fever episodes but has not advised any premeds yet. I will remember to ask him about it next time.

I have confirmed several times with the Blood Transfusion bank about whether they check the blood for antibodies. They normally take about 1-2 hours to check and cross match compatible blood for leucoreduced pRBC. So I beleive the blood must be compatible. Other than 'antibody' check is there are any other requirement for compatible blood?

[riccd2001]

AFAIK our lab checks for certain donor antigens to confirm "negative" before releasing the bag for transfusion. I would think that each patient has their own
set of antigens to be avoided. For example, the 'Phenotype Tag' for my 232nd transfusion was indicated "negative" for C^W and Jk^a.

[Mseth]

Thanks Ric. This is the first I am hearing of these antigens. Till now, I beleived that antigens were compatible as long as the blood group matched. My mother is O+. I will search the web for more information and educate myself on this aspect, as well as note it down for my next appointment with the hematologist and blood lab doctor.
Thanks very much.

[Mseth]

Can persistent low grade fever be due to mds? Is it a cause of worry?