While blood transfusion is, in many respects, safer than it has ever been, the risks associated with transfusion are still present and must be evaluated against the benefit provided by transfusion.
The following information has been compiled to provide both current infectious risks and non-infectious risks of blood transfusion. References to support this information are given at the bottom.
|AGENT||RISK PER UNIT TRANSFUSED|
|Parvovirus B19 (erythrovirus)||Unknown; about 12 cases reported in the literature|
|Bacteria (platelets)||1: 5,000 (tested)|
|Hepatitis A virus||1:1 million|
|Hepatitis B virus||1:850,000 to 1:2 million|
|Hepatitis C virus||1:1,150,000|
|HIV (Human Immunodeficiency virus)||1:2 million|
|Human T-lymphotrophic virus||1:200,000 to 1:500,000|
|West Nile virus||Unknown but varies by season; about 11 cases reported in the literature since 2003|
|Adverse Outcome||Risk Per Unit Transfused||Clinical Signs & Symptoms|
|Acute hemolytic||1:40,000 to 1:70,000||Chills, fever, pain at infusion site, hemoglobinuria, shock, acute renal failure, flank pain, DIC|
|Allergic - simple||1:100 to 3:100||Flushing, hives, itching|
|Allergic - severe||1:20,000 to 1:50,000||Hypotension, respiratory distress, wheezing, local edema|
|Transfusion associated circulatory overload (TACO)||1:100 to 11:100||Dyspnea, hypertension, pulmonary edema|
|Delayed hemolytic||1:5,000 to 1:11,000||Drop in hemoglobin, increased indirect bilirubin, new RBC antibodies|
|Febrile non-hemolytic||1:100 (prestorage leukoreduced products)||Fever with greater than 1°C change, chills, rigors|
|Graft versus host disease||Rare||Rash, diarrhea, hepatitis, pancytopenia|
|Transfusion-related acute lung injury (TRALI)||8:100,000||Hypoxemia, dyspnea, hypotension, non-cardiogenic pulmonary edema|
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