Association of Veterinary Hematology and Transfusion Medicine (AVHTM) transfusion reaction small animal consensus statement (TRACS). Part 3: Diagnosis and treatment

Abstract

Objective To systematically review available evidence to develop guidelines for diagnosis and treatment of transfusion‐associated reactions in dogs and cats. Design Standardized and systemic evaluation of the literature (identified through Medline via PubMed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. The available evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. The evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines, diagnostic, and treatment algorithms were generated based on the evaluation of the evidence. Consensus on the final guidelines was achieved through Delphi‐style surveys. Draft recommendations were disseminated through veterinary specialty listservs for review and comments, which were evaluated and integrated prior to final publication. Results Medline via PubMed and Google Scholar databases were searched. There were 14 Population Intervention Comparison Outcome questions identified and corresponding worksheets were developed focusing on the diagnosis and treatment of transfusion‐associated reactions in dogs and cats. Fourteen guidelines and four algorithms were developed with a high degree of consensus. Conclusions This systematic evidence evaluation process yielded recommended diagnostic and treatment algorithms for use in practice. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine.

Development and Evaluation of a Serum Transfusion Process in the Thorny Devil Stick Insect (Eurycantha calcarata)

“…Recalling that no other clinical side effects were appreciated throughout the assessment period, this supports the notion that serum transfusions are largely well-tolerated in this species, with the caveat that clinical assessment of this species is challenging and more subtle signs of a transfusion reaction may not have been clinically apparent. On a similar note, transfusion reactions have been reported in companion animals for up to 12 days following administration, thus, late transfusion reactions beyond the 7-day assessment period may have been missed ( 20 , 21 ).…”

“…Reactions to transfusions can range from mild to severe and can, in some circumstances, result in death. Clinical signs of transfusion reactions in companion animals may include changes in respiratory character (tachypnea, dyspnea), cardiovascular disturbances (hypotension, tachycardia), pyrexia, facial edema, chemosis, and/or anaphylaxis ( 20 , 21 ). In invertebrates, clinical signs of transfusion reactions have not been described.…”

Alloimmunization in dogs after transfusion: A serial cross‐match study

“…Because the influence of treatment with immunosuppressants on the occurrence of transfusion reactions could not be proven in a previous study in dogs, 48 premedication with glucocorticoids before transfusion is not recommended in veterinary medicine. 49 However, it is questionable whether treatment could have an effect on alloimmunization. In human medicine, several studies have already described a lower rate of alloimmunization by treatment with immunosuppressants.…”

Evaluating the Possibility of Transfusion Medicine, Through Crossmatching in Juvenile Galapagos Sea Lions (Zalophus wollebaeki)

“…Regardless, if a Galapagos sea lion receives a blood transfusion from a conspecific, the animal must be constantly monitored for any signs of a transfusion reaction, regardless of crossmatch status. In companion animals, transfusion reactions have been recorded up to 12 days following a transfusion ( 24 , 25 ). Monitoring a Galapagos sea lion for 12 days following a transfusion may present a logistical challenge if a pre-arranged space is not available.…”