Transfusion reaction becoming more frequent ?

[deathcheater]

My meld score has actually improved from 11 to 9.  I usually am anemic.  Recent cause, bleeding stomach polyp resolved.  Used to have reaction of violent chills,  shaking, fast heartbeat, and rapid breathing.  Now I get leukocyte poor blood with a "y" filter.  Still reacted after 1 1/2 units with violent chills shaking, sometimes light fever.  After transfusion stopped shaking resolved in 30-45 min and then I was fine.  
  After polyp fix, Hct was 18 now 26.5 after two transfusions  totaling  1 and 1/2 units.  Knowing my reaction, I arranged to get one unit at  a time.  First unit fine    Six days later, another unit and my arm started to really hurt and then up to my shoulder, then the chills.  I stopped the transfusion.  I only got 1/2 a unit in.  As usual, I was fine in about 45 minutes.  I have them use a small needle and keep the blood flow slow.  Luckily, I tolerate low Hct well, but I am really tired of wasting blood.  I have not spoken to the blood bank to check their preparation of leuko poor blood.  Sites w/ studies I need are restricted.  Any help appreciated.

[Thomas D Schiano, MD]

i am not sure of anything prophylactic that you can do.  Always alert the blood bank about your history of such reactions.

[deathcheater]

Thanks for the idea.  Oops, I wasn't being clear.  Longstanding anemia has been improving as problems are resolved.  Transfusions are not regular events.  I've had one a year or so.  In between blood loss events I'm able to build up blood on my own now pretty quickly (4 pts Hct 1 week post transfusion). In the Procrit lit it says that is enough.  Avoiding transfusions is best, but I like to prepare, and was fishing for answers in case of emergency.

[Thomas D Schiano, MD]

maybe you should take procrit regularly.  You should clearly limit the # of transfusions that you receive.