Proposed mechanisms:
(1) antibodies in the recipient interact with antigens in the donor product associated with leukocytes and/or platelets.
(2) cytokines in the blood product or released by the recipient in response to the transfusion
Features of a febrile nonhemolytic transfusion reaction:
(1) temperature rise after infusion of a blood product not explainable by other cause. An increase >= 1°C (1.8° F) is often used, but lower or higher points may be selected.
(2) often accompanied by chills and/or rigors
(3) tends to occur in the multiply transfused patient or women after multiple pregnancies
(4) may occur during the transfusion, shortly after or a few hours later
False positive:
(1) previously hypothermic patient becoming normothermic
(2) reaction to surgery
(3) febrile reaction to medication
(4) concurrent infection
Other transfusion reactions in the differential diagnosis:
(1) hemolytic transfusion reaction
(2) transfusion-associated infection
(3) bacterial contamination of the blood product
Reduction of leukocytes in the infused product may prevent a febrile response.
(1) Reduction at the time of infusion is not as effective as reduction at the time of collection.
