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Estudio prospectivo de la prueba de activación de basófilos en la anafilaxia perioperatoria por transfusión
Yasuhiro Amano1, Tasuku Fujii1, Natsumi Kameyama2
1Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
The journal of allergy and clinical immunology. Global
|January 26, 2026
Resumen
La prueba de activación de basófilos (BAT) puede identificar los productos sanguíneos causales en la anafilaxia perioperatoria por transfusión. Esta anafilaxia es más común de lo que se pensaba, con plasma fresco congelado presentando el mayor riesgo.
Área de la Ciencia:
- Anestesiología
- Inmunología
- Hematología
Sus antecedentes:
- El diagnóstico de anafilaxia perioperatoria por transfusión es difícil debido a la falta de pruebas confirmatorias.
- La prueba de activación de basófilos (BAT) muestra promesa para el diagnóstico de reacciones transfusionales, pero su uso en anafilaxia perioperatoria no ha sido probado.
Objetivo del estudio:
- Evaluar la utilidad de la prueba de activación de basófilos (BAT) en el diagnóstico de anafilaxia perioperatoria por transfusión.
- Determinar la incidencia de anafilaxia perioperatoria relacionada con la transfusión de productos sanguíneos.
Principales métodos:
- Estudio prospectivo durante 4 años en un solo hospital.
- Se realizaron pruebas de activación de basófilos (BAT) en productos sanguíneos de pacientes que experimentaron sospecha de anafilaxia por transfusión durante anestesia general.
- El diagnóstico se confirmó mediante una BAT positiva y una alta puntuación de hipersensibilidad.
Principales resultados:
- La prueba de activación de basófilos (BAT) confirmó anafilaxia en el 55% de los pacientes.
- La incidencia de anafilaxia perioperatoria fue de 1/2,230, significativamente mayor que la informada previamente.
- El plasma fresco congelado (1/670) y el concentrado de plaquetas (1/1,292) tuvieron las tasas de incidencia más altas.
Conclusiones:
- La prueba de activación de basófilos (BAT) es una herramienta valiosa para identificar los productos sanguíneos causales en la anafilaxia perioperatoria por transfusión.
- La anafilaxia perioperatoria debida a productos sanguíneos puede estar subdiagnosticada y ocurre con más frecuencia de la estimada previamente.
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