The patient may complain of discomfort and anxiety or may have no symptoms. There may be breathing difficulty, fever and chills, facial flushing, and severe pain, especially in the lumbar area. Evidence of shock may appear, with a rapid feeble pulse, cold clammy skin, dyspnea, a drop in BP, and nausea and vomiting. An elevated serum bilirubin level and clinical jaundice follow. AHTR may occur under general anesthesia, when most symptoms are masked.
Prognosis depends primarily on the severity of the reaction.
Prolonged oliguria and shock are poor prognostic signs. Prophylaxis and Treatment AHTR is best prevented through careful checking of compatibility and the correctness of the blood component and identification of the recipient. If AHTR is suspected, the transfusion should be stopped and supportive treatment begun immediately. The goal of initial therapy is to achieve and maintain adequate BP and renal blood flow. Antihypertensive drugs must be administered with caution, and pressor drugs that decrease renal blood flow are contraindicated.