Final answer:
The main complication to consider during a PRBC transfusion is Hypersensitivity reactions, specifically hemolytic transfusion reactions (HTR), which are serious type II hypersensitivity reactions leading to the destruction of incompatible transfused RBCs.
Step-by-step explanation:
A primary concern when identifying complications during the transfusion of packed red blood cells (PRBCs) is Hypersensitivity reactions. This type of complication is specifically known as a hemolytic transfusion reaction (HTR), which is a condition resulting after an incompatible blood transfusion. It is categorized as a type II hypersensitivity reaction, where the recipient's immune system attacks the transfused RBCs due to the presence of incompatible antigens. When RBCs from an incompatible blood type are introduced, the body recognizes these cells as foreign. For example, if a person with type B blood receives a transfusion of type A blood, anti-A antibodies in the recipient will bind to and agglutinate the incompatible RBCs. In addition, the activation of the classical complement cascade leads to massive hemolysis, resulting in symptoms such as fever, chills, itching, hives, dyspnea, lung and kidney vessel occlusion due to RBC debris, and potentially life-threatening low blood pressure.