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Do Children With an Allergic Transfusion Reaction Require Premedication For All Blood Products?
Aban Bahabri1,2, Rebecca Barty3, Na Li3,4,5
1Department of Pediatrics, McMaster University, McMaster Children's Hospital.
Insights
Children with a history of allergic transfusion reactions (ATRs) rarely develop new reactions to different blood products. Premedication for subsequent, different blood product transfusions is likely unnecessary.
Area of Science:
- Pediatric Hematology
- Transfusion Medicine
- Immunology
Background:
- Children with a history of allergic transfusion reactions (ATRs) often receive premedication to prevent future events.
- The efficacy of premedication for subsequent transfusions of different blood product types is not well-established.
Purpose of the Study:
- To investigate the incidence of ATRs in children following transfusions with different blood product types after a prior ATR.
- To evaluate the necessity of routine premedication for subsequent transfusions of different blood product types.
Main Methods:
- Retrospective chart review of pediatric patients who experienced ATRs.
- Data sourced from the Transfusion Transmitted Injuries Surveillance System- Ontario database.
- Analysis of demographics and subsequent transfusion records.
Main Results:
- Thirty-eight ATRs occurred in 30 out of 4153 patients receiving 35,925 blood products.
- Seven patients (23%) experienced multiple ATRs, exclusively to the same blood product type.
- No ATRs were observed in 60 subsequent transfusions of different blood product types to these 7 patients.
Conclusions:
- Developing allergic transfusion reactions to different blood product types is uncommon in pediatric patients with a history of ATR.
- Routine premedication for subsequent transfusions of different blood product types may not be warranted.
Background:
Children with a history of allergic transfusion reactions (ATRs) receive antihistamine premedication with or without hydrocortisone to prevent subsequent reactions. We aim to examine the frequency of developing ATRs to subsequent different blood product type transfusions.
Methods:
A retrospective chart review of children who received blood product transfusions (packed red blood cells, platelets, frozen plasma, intravenous immunoglobin, albumin, and cryoprecipitate) and developed ATRs. Cases were identified through Transfusion Transmitted Injuries Surveillance System- Ontario database with a complementary chart review. Demographics and subsequent transfusions records were described.
Results:
During this period, 35,925 blood products were transfused to 4153 patients. Thirty-eight ATRs were reported in 30 patients. All ATRs were minor except 1 anaphylaxis to albumin transfusion. Seven patients (23%) developed multiple ATRs, and all of them were of the same blood product type. A total of 60 subsequent different blood product types were transfused to the 7 patients who had multiple ATRs; none of those transfusions caused ATR.
Conclusion:
In children with a history of ATR, developing a reaction to a different blood product type is rare. Hence, premedicating those transfusions is not warranted.
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