Adverse Effects of Blood Transfusion

The adverse effects of transfusion and their frequency are shown in Table 4:

Table 4: Risks Associated with Transfusion of Blood Components

 

Risk

Type of Risk

Frequency

Hemolytic reaction

Acute

1:13,000

Delayed

1:9,000

Febrile, non-hemolytic

 

1:500; 1:15 platelet pools

TRALI

 

1:100,000; 1:10,000 platelet pools

Allergic

 

1:250; 1:25 platelet pools

Anaphylaxis

 

1:23,000; 1:1,600 platelet pools

Graft vs Host disease

 

Probably <1:1 million

Circulatory overload

 

~ 1% of recipients

Air embolism

 

Very rare

Exogenous material

 

Very rare

Hypothermia

Citrate toxicity

Hyper/hypokalemia

 

Unlikely unless >1.5 blood volumes transfused

Iron Overload

 

Begins after 20th unit

Alloimmunization

RBCs

8% of recipients

Platelets

50% in multiply transfused

Viral infections

HIV

1:4 million

HTLV-I & II

Virtually nil

HAV

Very rare

HBV

1:31,000 to 1:82,000

HCV

1: 3 million

HGV

Common, no known disease

TTV

Common, no known disease

CMV

Unknown; CMV neg to high risk

Parvovirus B19

Disease rare

WNV

See recent CBS info

Prions

CJD, vCJD

Theoretical

Bacterial agents

Sepsis, severe symptomatic

1:500,000; 1:10,000 platelet pools

Syphilis

Virtually nil

Ehrlichiosis

Very rare

Lyme disease

Theoretical

Parasites

Malaria

1:4 million

Babesiosis

Very rare

Chagas’ disease

Very rare


The above information is mainly derived from data published by Kleinman et al (2003), Ref. 18,19.