Abdul Mannan: Recognition and Management of Febrile Non-Haemolytic Transfusion Reactions in Clinical Practice
Abdul Mannan, Consultant Hematologist at Betsi Cadwaladr University Health Board, shared a post on LinkedIn:
“FNHTR is the most common transfusion reaction — but its real danger is that it can mimic the early signs of a haemolytic transfusion reaction (HTR), which is life-threatening.
The hook should create that tension: common but terrifying until proven otherwise.
Fever during a blood transfusion.
Every junior doctor freezes.
Is this dangerous?
Do I stop the blood?
Is my patient haemolysing?
Most of the time? It’s FNHTR.
But you can’t assume that.
Here’s the framework:
What’s happening:
- Recipient antibodies attack donor white cells
- Or cytokines accumulate in the stored bag
- Result: fever ≥38°C or a ≥1°C rise, with chills and rigors
The diagnosis is by exclusion:
- No hypotension
- No respiratory distress
- No haemolysis
If ANY of these are present — think harder.
What to do:
- STOP the transfusion immediately
- Send blood for labs (FBC, DAT, repeat group and screen)
- Give paracetamol
- Only RESTART slowly once you’ve ruled out something serious
Prevention:
- Leucodepletion of blood components
- All UK blood products are now leucodepleted — this has cut FNHTR rates dramatically
The 2023 SHOT report still lists FNHTR as the most reported transfusion complication in the UK.
Common doesn’t mean trivial.
When you stop that bag — you’re not overreacting.
You’re doing exactly the right thing.
What’s the most challenging transfusion reaction you’ve managed?”
Other posts from Abdul Mannan on Hemostasis Today.
-
Jun 25, 2026, 15:06Ifeanyichukwu Ifechidere: What If One of the Biggest Myth Fact About Antiphospholipid Syndrome (APS) Is Hidden in its Name?
-
Jun 25, 2026, 15:05Gopal Patidar: Advancing Haemovigilance and Global Collaboration at ISBT 2026
-
Jun 25, 2026, 14:52Violeta Jardin: Measuring Antifibrinolytic Effect to Improve Tranexamic Acid Safety
-
Jun 25, 2026, 14:34Heghine Khachatryan: Hemostasis at the Crossroads of Immunity and Inflammation
-
Jun 25, 2026, 14:30Jean-Jacques Kiladjian: Building the Next Generation of MPN Leaders
-
Jun 25, 2026, 14:29Shadi Tabibian: Navigating Modern Diagnosis and Individualized Care in Hemophilia A and B
-
Jun 25, 2026, 14:17Kuhu K.: We Need to Break the Silence on Mental Health After Stroke
-
Jun 25, 2026, 14:13Christelle Orlando: 3 open Co-Chair Positions within the ISTH SSC Subcommittee on PAT
-
Jun 25, 2026, 14:10Brian A Beh: The Ten Truths That Changed How I Understand Stroke Recovery