EC Microbiology

Introduction: A side reaction or adverse event is known as the development of an undesirable unexpected effect or response in a patient following the administration of blood or any blood component. In current practice, even within developed countries, the highest risk to the patient is considered to be the non-infectious adverse events following transfusions that are responsible for a significantly high morbidity and mortality rates. In this review, the non‑infectious complications which are related to blood transfusions were defined as non‑infectious adverse transfusion reactions (NIATRs). The American Association of Blood Banks technical manual suggests guidance for the detection, diagnosis, management and grouping of non-infectious transfusion reactions, that could serve as a ready reference for physicians and other related health providers who deal continuously with blood transfusion. The acute and late non-infectious adverse transfusion reactions are categorized based on time of occurrence and later subdivided according to supposed etiology into immune-mediated subtype and non-immune mediated subtype.

Aim of Work: In this review, we will discuss blood transfusion and complications

Methodology: We did a systematic search for Blood transfusion and complications using PubMed search engine (http://www.ncbi. nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles.

Conclusions: Acute transfusion reactions are generally responsible for causing many serious side effects and complications. Awareness about various clinical manifestations and characteristics of acute transfusion reactions with the ability to evaluate the serious complications on a timely manner could lead to a better prognosis. Observation and strict monitoring are essential throughout the blood transfusion period, especially within the first fifteen minutes. There must be a standard operating procedure that contains the details for documentation, reporting, evaluation, and follow-up of all side effects and complications. Evidence based protocols of Restrictive strategy” or “Conservative approach” of blood transfusion to decrease the rate of unwanted blood transfusions has led to a significant improvements in current clinical practice.

Keywords: Blood Transfusion; Complications; Non-Infectious

1. Popovsky MA., et al. “ISBT Working Party on Haemovigilance. Proposed standard definitions for surveillance of noninfectious adverse transfusion reactions” (2011).
2. Hendrickson JE and Hillyer CD. “Noninfectious serious hazards of transfusion”. Anesthesia and Analgesia3 (2009): 759-769.
3. Mazzei CA., et al. “Noninfectious complications of blood transfusion”. In: Roback JD, Combs MR, Grossman BJ, et al., eds. Technical Manual, 16th Edition. Bethesda, MD: American Association of Blood Banks (2008): 715-749.
4. “Manual of Clinical Use of Blood in Surgery and Anaesthesia” (2014).
5. Heddle NM., et al. “A randomized controlled trial comparing plasma removal with white cell reduction to prevent reactions to platelets”. Transfusion3 (1999): 231-238.
6. Hennino A., et al. “Pathophysiology of urticaria”. Clinical Reviews in Allergy and Immunology1 (2006): 3-11.
7. Domen RE and Hoeltge GA. “Allergic transfusion reactions: An evaluation of 273 consecutive reactions”. Archives of Pathology and Laboratory Medicine3 (2003): 316-320.
8. Tang AW. “A practical guide to anaphylaxis”. American Family Physician 68.7 (2003): 1325-1332.
9. Ellis AK and Day JH. “Diagnosis and management of anaphylaxis”. Canadian Medical Association Journal4 (2003): 307-311.
10. Bux J and Sachs UJ. “The pathogenesis of transfusion-related acute lung injury (TRALI)”. British Journal of Haematology 136.6 (2007): 788-799.
11. Goldberg AD and Kor DJ. “State of the art management of transfusion-related acute lung injury (TRALI)”. Current Pharmaceutical Design22 (2012): 3273-3284.
12. Müller MC., et al. “Low-risk transfusion-related acute lung injury donor strategies and the impact on the onset of transfusion-related acute lung injury: A meta-analysis”. Transfusion1 (2014): 164-175.
13. Bolton-Maggs PH and Cohen H. “Serious Hazards of Transfusion (SHOT) haemovigilance and progress is improving transfusion safety”. British Journal of Haematology3 (2013): 303-314.
14. Blumberg N., et al. “An association between decreased cardiopulmonary complications (transfusion-related acute lung injury and transfusion-associated circulatory overload) and implementation of universal”. Transfusio12 (2010): 2738-2744.
15. Kalra A., et al. “Acute hypotensive transfusion reaction with concomitant use of angiotensin-converting enzyme inhibitors: A case report and review of the literature”. American Journal of Therapeutics2 (2012): e90-e94.
16. Bordin JO and Blajchman MA. “Transfusion associated immunomodulation. Rossi’s Principles of Transfusion Medicine”. 3rd edition. Philadelphia: Lippincott Williams and Williams (2002): 867-877.
17. Ghio M., et al. “In vitro immunosuppressive activity of soluble HLA class I and Fas ligand molecules: Do they play a role in autologous blood transfusion?” Transfusion8 (2001): 988-996.