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Table 9-1

Risks of Transfusion Complications

FREQUENCY, EPISODES: UNIT
Main reactions

Circulatory overload (TACO)

Febrile (FNHTR)

Allergic

TRALI

Delayed hemolytic

Acute hemolytic

  • 10.9:100,000
  • 100-1000:100,000, frequently under reported
  • 100-400:100,000, product-dependent
  • 0,4-1:100,000, with mitigation, product-dependent
  • 40:100,000
  • 2.5-7.9:100,000
Infectionsa

Bacteria (septic transfusion reaction)

Hepatitis B

Hepatitis Cb

HIV-1,b -2

HTLV-I and -II

Malaria

  • 0,3-25:1,000,000 (product and detection- or pathogen-reduction-dependent
  • 1:300,000 (<1:1,000,000b )
  • <0,1-1:1,000,000
  • 0,1-1:1,000,000
  • 1:3,000,000
  • 1:4,000,000
Other complications

RBC allosensitization

HLA allosensitization

Graft-versus-host disease

  • 1:100
  • 1:10 (in the absence of leukodepletion)
  • Extremely rare (with blood product irradiation in immunosuppressed pts)

a Other infectious agents associated with transfusion include arbovirus (West Nile virus, Dengue virus, Zika virus) hepatitis A and E virus, parvovirus B-19, Babesia microti and Babesia duncani (babesiosis), Anaplasma phagocytophilum (human granulocytic ehrlichiosis), Trypanosoma cruzi (Chagas disease), Treponema pallidum, and human herpesvirus-8. Frequency of infectious risks differs significantly worldwide.

b With nucleic acid testing (NAT) screening.

Abbreviations: FNHTR, febrile nonhemolytic transfusion reaction; HTLV, human T lymphotropic virus; RBC, red blood cell; TACO, transfusion-associated circulatory overload; TRALI, transfusion-related acute lung injury.