What is a febrile nonhemolytic transfusion reaction (FNHTR)?

By William Aird

Defined as ≥ 1 degrees C increase in temperature ≥ 38 degrees C (100.4 degrees F) that is associated with transfusion and no other causes are evident. Caused by antibody to donor leukocytes. Symptoms include:

  • Fever
  • Chills
  • Tachypnea
  • Headache
  • Vomiting

According to the AABB, febrile nonhemolytic transfusion reaction defined as fever and/or chills without hemolysis occurring
in the patient during or within 4 hours of cessation of transfusion. If transfusion-related, the most common cause is a reaction to passively transfused cytokines or a reaction of recipient antibodies and leukocytes in the blood product. If blood culture of patient or residual component is performed, the results should be negative. Laboratory findings should show no evidence of
acute hemolysis.

Treatment includes antipyretic such as acetaminophen or meperidine (for more severe reactions).

Administer leukocyte-reduced blood or washed RBCs to reduce risk.