Acute transfusion reactions

Area of Science:

• Hematology
• Transfusion Medicine
• Clinical Pathology

Background:

• Acute transfusion reactions (ATRs) are a significant concern in blood product administration.
• Understanding the incidence and characteristics of ATRs is crucial for patient safety.
• Previous studies have highlighted varying rates and types of reactions across different blood products.

Purpose of the Study:

• To analyze the incidence, clinical features, and laboratory findings of acute transfusion reactions.
• To identify the most common blood products associated with reactions and their specific symptoms.
• To evaluate the diagnostic yield of laboratory investigations in determining the etiology of ATRs.

Main Methods:

• Retrospective review of 1500 acute transfusion reactions reported over a 7-year period.
• Analysis of transfusion data from approximately 440,000 transfusions.
• Categorization of reactions by blood product type, symptom presentation, and serological findings.

Main Results:

• Red blood cell transfusions had the highest reaction incidence (0.73%).
• Common symptoms included fever (72%), rigors (33%), and rash/urticaria (30%), mostly mild and transient.
• Only 12% of reactions showed identifiable serological abnormalities, with six cases of autoantibodies.

Conclusions:

• Most acute transfusion reactions are mild and transient, with red cells posing the highest risk.
• Current laboratory investigations have limited utility in accurately diagnosing the cause of most ATRs.
• A rationalized approach to investigating acute transfusion reactions is recommended to improve diagnostic efficiency.