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2022, Número 2

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Rev Cubana Hematol Inmunol Hemoter 2022; 38 (2)


Eventos adversos en la práctica transfusional: reacción transfusional hemolítica inmune

Soler NG, Fernández DND

Idioma: Español
Referencias bibliográficas: 63
Paginas: 1-23
Archivo PDF: 333.07 Kb.


RESUMEN

Introducción: Las reacciones hemolíticas transfusionales inmunológicas ocurren por incompatibilidad del paciente con los eritrocitos o el plasma del donante y se dividen en reacciones hemolíticas inmediatas y tardías.
Objetivo: Explicar los mecanismos fisiopatogénicos, el diagnóstico, manejo y tratamiento de la reacción transfusional hemolítica inmune.
Métodos: Se realizó una revisión de la literatura en los idiomas inglés y español de artículos publicados en los últimos 10 años referidos al tema, a través del sitio web PubMed y el motor de búsqueda Google académico.
Análisis y síntesis de la información: Las reacciones hemolíticas transfusionales inmunológicas se dividen en agudas o inmediatas y retardadas o tardías. La gravedad depende fundamentalmente del tipo y cantidad de antígenos, aloanticuerpos, la capacidad para activar el sistema de complemento y del sistema mononuclear fagocítico. Los avances en la comprensión de la fisiopatología de esta reacción ayudan a evaluar clínicamente a los pacientes y tratarlos de manera eficaz. Es probable que cuando se logre la modificación de los eritrocitos y el uso de sustitutos, cambie significativamente la práctica transfusional en el futuro y elimine la aparición de estas reacciones.
Conclusiones: Las reacciones hemolíticas transfusionales inmunológicas son sin dudas muy graves, pero son perfectamente evitables con el cumplimiento de las normas de buenas prácticas de los bancos de sangre y servicios de transfusiones. El progreso en la comprensión de la fisiopatología de esta reacción contribuye a una mejor evaluación clínica y un tratamiento eficaz.


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