An Investigation of Nonhemolytic Transfusion Reactions

Decary, F.; Ferner, P.; Giavedoni, L.; Hartman, A.; Howie, R.; Kalovsky, E.; Laschinger, Carol; Malette, M.; Martyres, A.; Mervart, H.; Naylor, D.H.; Rose, J.E.M St.; Shepherd, F.A.; Tibensky, D.

doi:10.1159/000466194

Cited by 34 publications

(14 citation statements)

References 10 publications

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“…It has been known for a long time that transfusion of blood components may cause febrile reactions due to leukocyte [8] or platelet antibodies in patients who had received previous transfusions. In the patients studied by Decary et al [3], 64% of patients with nonhemolytic transfusion reactions had leukocyte antibodies as compared to 30% of control patients. De Rie et al [1] further characterized antibodies as human leukocyte antigen (HLA-), platelet-and granulocyte antibodies in patients with febrile reactions.…”

Section: Febrile Non-hemolytic Transfusion Reactionsmentioning

confidence: 90%

“…Their true incidence has therefore been difficult to assess. Decary et al [3] estimated the incidence for nonhemolytic transfusion reactions by 0.4% (of products transfused) in patients receiving platelet concentrates; probably, most of these reactions were febrile reactions. Enright et al [4] reported a rise in temperature in 0.3% of transfusions, but they found transfusion reactions in 1.6% of transfusions if chills with rigors were included in the analysis.…”

Section: Febrile Non-hemolytic Transfusion Reactionsmentioning

confidence: 99%

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Reactions Induced by Platelet Transfusions

Kiefel¹

2008

Transfus Med Hemother

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Platelet transfusions play a central role in therapeutic regimens for patients with hematologic/oncologic diseases who develop severe thrombocytopenia either in the course of their disease or following cytostatic therapy. Like other blood components, platelet transfusions have achieved a high degree of safety as far as transmission of viral diseases is concerned. However, transfusion of platelet concentrates is accompanied by a high frequency of febrile and anaphylactoid reactions. In rare cases, recipients of platelet concentrates are threatened by severe reactions as septic complications due to bacterial contamination of platelet concentrates, transfusionrelated acute lung injury and severe anaphylactic episodes.

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Section: Febrile Non-hemolytic Transfusion Reactionsmentioning

confidence: 90%

Section: Febrile Non-hemolytic Transfusion Reactionsmentioning

confidence: 99%

Reactions Induced by Platelet Transfusions

Kiefel¹

2008

Transfus Med Hemother

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“…In fact, they stimulate the production of alloantibodies directed against both HLA and leukocyte-specific anti gens [1][2][3] that in turn can be the cause of the febrile transfusion reaction [4,5] and of refractoriness to platelet transfusion [6,7]. Moreover, some viruses, such as cyto megalovirus (CMV), can be transmitted by leukocytes [8].…”

Section: Introductionmentioning

confidence: 99%

The Clinical Importance of Leukocyte Depletion in Regular Erythrocyte Transfusions

Sirchia¹,

Rebulla²,

Mascaretti³

et al. 1986

Vox Sanguinis

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Antilymphocyte, antigranulocyte and antiplatelet alloantibodies, T lymphocyte subsets, expression of HLA-DR antigens on T lymphocytes and NK cell function were determined in 11 homozygous β-thalassemic children multitransfused ab initio with Erypur-filtered leukocyte-free red cell units (group A) and in 13 similar children multitransfused with standard packed red cell units (group B). No antibodies were found in group A patients, whereas 69% of group B patients were immunized. The two groups did not differ significantly with regard to the other test results. Considered together, thalassemia patients showed a percentage of T4+ cells and a NK cell function that were significantly lower than those found in a reference group of 16 healthy male blood donors. Thalassemics moreover showed a higher than normal percentage of T3+, T4+ and T8+ cells expressing HLA-DR antigens. The results indicate that leukocyte-free red cells should be the treatment of choice for prospective recipients of multiple transfusions, since they are capable of preventing (or delaying) the production of alloantibodies against leukocytes and platelets. From the data of the present study, it does not seem that the transfusion of leukocyte-free red cells is capable of preventing the abnormalities of some immunological tests that occur in some multitransfused patients. Further investigations, however, are needed to draw conclusions on this problem.

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“…Wolf and Canale [6] detailed a fatal reaction to a red cell transfusion in a multitransfused thalassémie child with lymphocytotoxic HLA antibodies. Several recent studies have shown that the most common ly found recipient antibodies associated with nonhemo lytic febrile transfusion reactions are not directed towards granulocyte antigens but are lymphocytotoxic, directed against HLA antigens [5,8,9], Interdonor red cell incompatibility in the Kell antigen system has caused reactions of variable severity [19][20][21][22][23]. Interdonor reactions caused by RBC transfusions have been described in which the transfusion of Kell-negative red cells with Kell antibody in donor plasma at the same time as another unit of Kell-positive red cells has caused a hemolytic transfusion reaction when both units were transfused to a Kell-negative patient [19,20].…”

Section: Discussionmentioning

confidence: 99%

Platelet Transfusion Reaction Associated with Interdonor HLA Incompatibility

Eastlund¹,

McGrath²,

Burkart³

1988

Vox Sanguinis

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An HLA-compatible platelet transfusion was followed by chills, fever, and severe respiratory distress in a multitransfused patient with chronic lymphocytic leukemia. During the previous 7 days the patient had received blood products without incident, including 8 units of red blood cells (RBC), 24 units of pooled random donor platelet concentrates, and five HLA-compatible platelet pheresis products. The patient had no demonstrable RBC, HLA lymphocytotoxic, platelet or granulocyte antibodies. The platelet donor, a multiparous female, had no granulocyte or RBC antibodies but had lymphocytotoxic antibodies against HLA-A2 CREG (cross-reacting group A2, A28, A23, A24) which reacted not with lymphocytes of the patient but with lymphocytes of the donor whose RBC were transfused 24 h prior to the platelet transfusion reaction and whose HLA type is A23, A24; B44, B57. No RBC donors had HLA lymphocytotoxic, granulocyte, or platelet antibodies against the platelet donor. The patient received three subsequent platelet transfusions from the same donor after removal of the antibody-laden plasma with no adverse reaction. These data suggest an interdonor reaction caused by the presence of cells from the RBC donor received by the patient 24 h prior to the transfusion of donor lymphocytotoxic antibody to HLA-A2 CREG antigens.

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An Investigation of Nonhemolytic Transfusion Reactions

Cited by 34 publications

References 10 publications

Reactions Induced by Platelet Transfusions

Reactions Induced by Platelet Transfusions

The Clinical Importance of Leukocyte Depletion in Regular Erythrocyte Transfusions

Platelet Transfusion Reaction Associated with Interdonor HLA Incompatibility

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