Febrile nonhemolytic transfusion reactions involve a rise in the recipient's body temperature associated with blood product transfusion without hemolysis or other explanation.


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.


To read more or access our algorithms and calculators, please log in or register.