Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS). Part 1: Definitions and clinical signs

Abstract

Objective To use a systematic, evidence‐based consensus process to develop definitions for transfusion reactions in dogs and cats. Design Evidence evaluation of the literature was carried out for identified transfusion reaction types in dogs and cats. Reaction definitions were generated based on synthesis of human and veterinary literature. Consensus on the definitions was achieved through Delphi‐style surveys. Draft recommendations were made available through industry specialty listservs and comments were incorporated. Results Definitions with imputability criteria were developed for 14 types of transfusion reactions. Conclusions The evidence review and consensus process resulted in definitions that can be used to facilitate future veterinary transfusion reaction research.

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

“…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.…”

Acute and severe haemorrhage following pentosan polysulfate injection in a Cornish Rex

“…Other transfusion-related reactions such as transfusion-related acute lung injury (TRALI) or transfusion-associated dyspnoea (TAD) may also have caused similar signs of respiratory distress in a cat with recent transfusion, but evidence of pulmonary oedema was not present on thoracic radiographs taken more than 6 h after the end of the transfusion, making TRALI less likely, 23 and TAD is less suspected given the evidence of existing heart disease and the possibility of TACO being more likely explanations. 23 Pulmonary oedema was found at post-mortem examination, which may have developed closer to the time of euthanasia, either as a result of the cat’s acute decompensation during its final moments, or – in conjunction with the pleural effusion (which had increased based on post-mortem findings compared with earlier echocardiographic findings) – as a manifestation of decompensated heart failure. The histological findings documented endocardial inflammation in the region of the DUST, which can be found in cats with endomyocarditis, a cardiomyopathy unique to cats; 21 the relative significance of this is unclear as the clinical findings were more consistent with hypertrophic rather than restrictive cardiomyopathy.…”

“…An underlying cause could not be identified as DUST is usually a benign finding in older cats, 22 although focal hypertrophic cardiomyopathy could not be ruled out. Other transfusion-related reactions such as transfusion-related acute lung injury (TRALI) or transfusion-associated dyspnoea (TAD) may also have caused similar signs of respiratory distress in a cat with recent transfusion, but evidence of pulmonary oedema was not present on thoracic radiographs taken more than 6 h after the end of the transfusion, making TRALI less likely, 23 and TAD is less suspected given the evidence of existing heart disease and the possibility of TACO being more likely explanations. 23 Pulmonary oedema was found at post-mortem examination, which may have developed closer to the time of euthanasia, either as a result of the cat's acute decompensation during its final moments, or -in conjunction with the pleural effusion (which had increased based on post-mortem findings compared with earlier echocardiographic findings) -as a manifestation of decompensated heart failure.…”

Xenotransfusion of Blood from Dog to Cat: Should Canine Blood Be Our First Choice for Feline Transfusion in Emergency Situations?

“…Cats have natural antibodies to erythrocytes of the other blood types of their species: type A cats have anti-type-B antibodies, and type B cats have a great number of antibodies against type A [ 19 ]. An allotransfusion with incompatible blood causes, at a minimum, haemolysis (in the case of a type-B donor and a type-A recipient), or at the worst death within a few minutes (in the case of a type-A donor and a type-B recipient) [ 26 ]. With cats it is thus not possible, as is the case with dog-to-dog transfusions, to perform a single transfusion without verifying compatibility; a cat must therefore not be transfused without prior blood typing, and ideally cross-matching.…”